An Overnight Success

February 2024 |

For one New England mixed animal practice, being there for clients means a whole lot more.

Mill Valley Veterinary Clinic in Belchertown, Mass., isn’t an emergency clinic, but the team is still ready and willing to help clients around the clock six days a week.

For example, when a St. Bernard needing exploratory abdominal surgery was brought to the practice late on a Thursday afternoon, practice owner Jesse Sugrue Koob, DVM, CVA, offered to remove the dog’s spleen instead of referring the dog to an emergency clinic.

Although the practice closed that evening at 7 p.m., she and her team stayed until after 10. This was not unusual for the practice: Mill Valley is a clinic that prefers to handle its own emergencies, even after hours.

True Dedication

Staffed by three full-time mixed animal practitioners, including Sugrue Koob, and one part-time small animal practitioner, Mill Valley is open six days a week. The three mixed animal practitioners rotate being on call Monday through Saturday during the hours the clinic is closed. Only during the period from Sunday at 6 a.m. until Monday at 8 a.m. will clients be directed to local emergency hospitals.

“Seeing our own emergencies definitely separates us from other local clinics,” says Sugrue Koob, who credits the previous owner for creating this offering that she has continued. “It’s so great to be able to give clients the option of after-hours urgent care from a practice they know and trust.”

Sugrue Koob also appreciates that she can offer that care without breaking the client’s bank. “All said and done, we charged the St. Bernard’s owner about a third of what an emergency hospital would have charged,” she says.

How It Works

When a call comes in after the clinic closes, the client is asked to leave a brief message, which is automatically forwarded to the on-call doctor’s cell phone. Sugrue Koob says each veterinarian sees about eight after-hours emergency calls per month. “There are some nights with no emergencies at all, but other nights you may have to drive out to a client’s farm at 3 a.m. to help birth a foal,” she adds.

Each mixed animal practitioner works every third Saturday, and they split the on-call during the week. A fourth practitioner is joining the team this summer, which means each doctor will be on call just one Saturday per month.

Each time the on-call veterinarians have to come into the practice or go to a farm to see a pet, they receive a small bonus in their next paycheck. The client cost for the visit is $120 (plus whatever testing and treatment are needed), of which the on-call doctor gets $70 and the clinic takes $50. “It’s a nice little perk,” Sugrue Koob says.

Clients pay the same price for an emergency visit regardless of the time of day. “It would probably make sense to charge extra for a 2 a.m. phone call, but that’s just not something we’ve done,” Sugrue Koob says. “To me, there’s a cutoff on what you need to make and still be successful.”

It Takes a Team

Success in handling emergencies is also a team effort at Mill Valley. “Emergencies happen at all hours of the day, so managing phone traffic and triage can be a real challenge for our front desk staff,” Sugrue Koob says. To handle the workload, three customer service representatives staff the front desk at all times that the clinic is open. Sometimes a floater is also scheduled to help out where needed, such as answering the phone, checking out client or filling prescriptions.

The Return

About 95% of the after-hours emergencies at Mill Valley can be taken care of by a single veterinarian, so the typical practice overhead is not a factor. “During business hours we are paying support staff and technicians to check clients in and out, handle billing and assist the doctor with care, but during on-call hours the doctors are doing all that themselves,” Sugrue Koob says.

Revenue has grown steadily since Sugrue Koob bought the practice in 2019. Gross sales were $2.08 million that year, jumping to $2.46 million in both 2020 and 2021, and climbing in 2022 to $2.68 million.

But what’s more important to Sugrue Koob is the peace of mind she gives her clients and the feeling of fulfillment she gets from emergency work. “You really get to know your clients so much better when you help them through an emergency,” she says, “and I’m saving more lives than I otherwise would on a day-to-day basis, so I have always found tons of fulfillment in it. And now as owner of the practice, it’s made me even more invested.”

Bigger and Even Better

Sugrue Koob is in the early stages of building a brand-new facility that will be almost double the size of the current one on more than quadruple the acreage. Expected to open in mid-2024, the practice will house five exam rooms, a euthanasia-specific room, a surgery suite twice the current size and a cat-specific ward. Plus, Sugrue Koob will have more space to work with the horses she cherishes. “We’ll be able to do in-house equine procedures that are difficult to do on a farm, such as giving intravenous fluids,” she says. “We’re super excited.”

Equipment Needs

Sugrue Koob names several pieces of required equipment for practices that offer emergency care, much of which a traditional practice may also have on hand:

  • In-house X-ray: $67K
  • Portable large animal X-ray machine: $48K
  • Gastroscope: $16K
  • Ultrasound: $35K
  • Blood machine: Typically free from the lab the practice uses for other testing