Many of our veterinary colleagues have told us of friends who, when looking for their first SA job, check for ‘No OOH’ before support, salary, level of equipment, degree of clinical freedom, location or opportunities for professional development.
Life is seldom that simple. A no-OOH practice cannot manage cases requiring overnight hospitalisation. This means that, when the practice closes, such cases must be shuttled off to an OOH facility and shuttled back in the morning. This is not uncommon but is probably not in the best health interests of a patient which, by definition, has been judged so in need of care that it cannot be managed at home. It is also looked upon with disapprobation by the RCVS, whose close attentions you can really do without.
Without OOH in your contract, you must refer anything which may require overnight hospitalisation for professional observation, intensive nursing or appropriate pain relief. You will go home every night off-duty, but that does not come without cost.
You will never do most orthopedics and certainly not spinal surgery. You will never do a TECA/LBO. You will never do diaphragmatic hernia repair, laryngeal tie-back, perineal or prescrotal urethrostomy, enterectomy or GDV. You will do many other surgeries at your peril, hoping that they will recover sufficiently to be able to go home by 6 pm. You will find this very stressful.
Medically, you will never take on cases which require ongoing monitoring, incremental pain relief or fluid therapy. You will never manage a case of acute pancreatitis, acute renal failure, severe HGE, pneumonia, repeated vomiting, severe vestibular disease, iliac thromboembolism, ketoacidotic diabetes mellitus or cluster seizures. You will never monitor urine output having relieved urethral obstruction or manage an in-dwelling catheter.
Diagnostically, you are less likely to ever see an MRI or CT scanner, a fully-equipped laboratory, a set of endoscopes or even DR or Doppler ultrasound. What’s the point of buying very expensive kit which reveals many problems that your no-OOH business model means you can’t treat? And if you don’t have them, you can’t learn how to use them.
We have everything and do everything listed above. Critically, so can you.
Let us summarise this in simple terms. You will never do interesting stuff in a no-OOH general practice environment.
We have a very relaxed out of hours and weekend rota which allows us all to have a life outside work. On most nights and weekends, you should be able to have a couple of drinks, paint the living room or babysit without fear of the dreaded ‘I don’t think he’ll last the night.’
And if you absolutely must be off on a night when you’re scheduled to be on duty, you can usually find colleagues who’ll swap in return for you covering a night they particularly want off.
Our out of hours work allows us to have the intellectual stimulus and, yes, fun, of an environment of complex case workups and clinical discussion, with often certificate-level support, mentoring and guidance.
Any recent graduate working in this practice is guaranteed to:
Too good to be true? Not at all. We provide all this, but don’t just take our word for it. Come to interview, see everything we have and the colleagues and nurses you would be working with, and we will provide you with lunch with a bunch of our younger graduates and senior nurses. You can ask them yourselves.