Information for Veterinarians

Our hospital is designed to function as an extension of the services you, the family veterinarian, provide to your clients. Our dedicated group of emergency clinicians and daytime specialists are available to you 24 hours a day, 365 days a year. Our goal is to provide the highest quality emergency, critical, and specialty care to your patients while working intimately with both you and your clients.

We're available for you and your clients when:

• A client has an emergency with their pet outside of your regular office hours.
• Faced with a complex medical or surgical case, you feel the client and patient may benefit from a consultation with one of our specialists.
• You would like to have an advanced diagnostic procedure such as Doppler color flow ultrasound, video endoscopy, bone marrow biopsy, etc. performed by one of our board-certified internal medicine specialists.
• You would like to refer a client for evaluation or surgery by our board-certified surgical specialist.
• A patient requires an examination or surgical procedure at a time that is impractical or inconvenient for you and your staff.
• You feel a patient requires intensive care or monitoring, including 24-hour case supervision.
• A patient requires advanced life-support equipment such as continuous oxygen administration, ventilation, or blood pressure monitoring.
• A patient requires or may require administration of blood products or constant rate infusion drug therapy.
• A client prefers that his or her pet receive overnight post-surgical or post-anesthesia monitoring and supervision of potential or realized complications and/or pain management.
• A patient is recovering from surgery or anesthesia and you recommend overnight monitoring for patient safety.

Our hospital has been specifically designed for emergency and specialty care with extensive glass observation and isolation wards to allow close patient monitoring. We have invested in advanced equipment to provide state-of-the-art care for your patients. Our specialists have the latest tools to diagnose and treat patients most effectively. Treatment and observation data are carefully documented to allow monitoring of patient trends and superior nursing care. Our team of highly trained doctors and technicians truly care about the outcome of every case.

Please note that we do not provide vaccinations or perform routine health procedures at our facility. Our practice is designed to support, not compete with, your general veterinary practice. Clients visiting our hospital are asked to identify their family veterinarian, allowing us to fax our detailed, typewritten medical record to the referral veterinarian for follow-up on the case. If a client has not yet established a relationship with a local veterinarian, we attempt to assist him or her in doing so using our detailed map of veterinary practices throughout the county. Once a family veterinarian has been selected, we fax a referral note and the patient's medical record.

We believe that, by working closely with you, our referring veterinarian, we are able to create a coordinated team of medical professionals, providing patients with the best possible comprehensive medical care.

We are available for emergency referrals 24 hours a day, 365 days a year. Our specialists are typically available for scheduled consultations on weekdays from 9 a.m. to 5 p.m.

Emergency services are provided when a client's family veterinarian is unavailable. If a client requests immediate care at our facility during regular business hours, and already has a family veterinarian, we direct the client to his or her family veterinarian. If the client has no family veterinarian, we may see the case but recommend that future care be performed with a family veterinarian. We then provide a referral to a family veterinarian based on the client’s location in the county.

Clients seen by our emergency service are typically advised they must pick up their pets by 8 a.m. on weekday mornings. If a patient is stable but requires continued care, the client is asked to transfer the pet to his or her family veterinarian. In such cases our emergency doctor will attempt to call the family veterinarian regarding the transfer. Records for all discharged patients are promptly faxed to the client’s family veterinarian.

If a patient is too unstable to safely transport to the family veterinarian on a weekday morning, or if a client specifically requests ongoing 24-hour care, we will continue care at our facility while promptly faxing records to the family veterinarian to keep him or her apprised of the case. If it appears that a patient may require a complex surgery, endoscopy, or ultrasound, we will make every effort to contact the family veterinarian to discuss the case and determine his or her preferences for case management. Obviously, the final decision regarding case management is made by the client.

Whenever possible, we strongly encourage clients to discuss their pet’s condition directly with their family veterinarian. We cannot, nor do we intend to, replace the important ongoing relationship and trust between clients and their family veterinarians. We routinely advise clients seen by our emergency service to follow up with their family veterinarian during regular business hours rather than returning to our facility.

Some clients with hospitalized pets indicate they are unable to transfer their pets to their family veterinarian on weekday mornings due to work schedules or other time conflicts. In these cases we typically offer the client the option of having one of our staff transport the pet. We charge only a minimal fee for this service (which is paid in full to our staff member to cover his or her time) as our goal is to return stable cases to our referring veterinarians and to make this transition as easy as possible for the client.

Your clients may be referred to our hospital by several different methods:

• Many area hospitals utilize an after-hours telephone message machine or answering service and provide clients with our telephone number for after-hours care. Other hospitals use a service that automatically transfers their after-hours calls to our telephone number. Our staff is happy to answer any questions your clients may have at times when you are unavailable. Staff members of PESCM have been trained to provide courteous, safe, honest, and medically accurate information.
• Your hospital may wish to display a small sign, which we provide at no cost, on your front door advising clients arriving after hours of the location and telephone number of our hospital. This has proven to be greatly appreciated by distressed clients who would otherwise have been uncertain about where to seek immediate assistance for their pet. Additionally, providing such notice is required by the Veterinary Medical Board.
• Other clients are referred to our facility directly from their family veterinary hospital to see one of our specialists or for continued after-hours care by our emergency service. If you would like to refer a case directly, please call us and ask to speak with the doctor on duty to briefly discuss the case. Our staff is trained to have the doctor on duty speak with you immediately unless working with a critical patient or in surgery.

If you have time, please complete one of our “Direct Referral Forms,” which can then be faxed in advance or sent with the client. Providing us with your medical record (including pertinent history, exam findings, and initial therapy), laboratory results, and radiographs for any transfer patient will greatly improve our ability to provide coordinated care. Additionally, feel free to share any suggestions you have regarding our ongoing management of the case.

Our goal is to provide quality, affordable veterinary care for your clients after hours and competitively priced specialty care. Obviously, our fees may be more than yours due to the high costs of staffing, equipping, and operating a 24-hour state-of-the-art emergency/specialty facility. Most of our clients appreciate the value of the services we provide and report that our fees compare favorably with other similar centers. Our emergency exam/office call fee remains one of the best values in the Bay Area.

Following a thorough intake examination, clients are provided with a detailed treatment plan recommended by the emergency doctor and estimate of fees. Our goal is to offer the best possible care for the pet by recommending optimal, but not excessive, diagnostics and therapeutics. We also recognize, however, that we must work within whatever budget a particular client establishes for the care of his or her pet. We understand that there is a wide variation in the motivation and financial resources of clients seeking emergency and specialty veterinary care.

A deposit of the low range of the estimate is required to begin procedures. Payment in full of any remaining balance is required at the time of completion of care. We accept cash, approved checks, and all major credit cards. We also offer the use of CareCredit for those clients with limited financial resources. Unfortunately, like other emergency facilities, we are unable to offer our own billing program. Upon discharge, clients are provided with a detailed invoice of their pet's charges. We welcome any questions that you or your clients may have about our financial policies and procedures.

We offer discounted services for personal pets of doctors and full time staff members of referring hospitals. Please let us know your affiliation upon arrival at our hospital. We will be pleased to provide you with a professional courtesy discount on all of our services.

Our goal is to keep you well informed regarding any of your clients and patients seen at our hospital. Medical records of patients seen by one of our specialists or emergency doctors are faxed immediately upon completion to the family veterinarian identified by each client. Patient updates are faxed each morning, including Saturday, for patients remaining under our care.

Digital radiographs are uploaded to a web site, e-mailed, or burned onto a disk that is provided to the client. When submitting laboratory tests to outside labs (Antech, Idexx, others), we typically request that duplicate results be sent to the family veterinarian identified by each client.

The overnight emergency doctor will generally call you to discuss any case transferring directly to your hospital that morning. Due to the number of clients sometimes being discharged in the early morning, the emergency doctor may not always be able to reach your hospital prior to the arrival of an emergency transfer. We appreciate your understanding in these cases and hope that our doctor's call will still be helpful to briefly summarize our care and impressions. Whenever possible, clients transferring pets directly to your hospital will arrive with a medical record in hand in addition to the complete record that is faxed to you at the time of discharge.

In general, the medical record will reflect any items such as an IV catheter, central line, indwelling urinary catheter, fentanyl patch, etc. remaining in place at the time of transfer or discharge. Should a transfer patient arrive at your hospital with a bandage in place, please carefully inspect the bandage to identify if an IV catheter is in place. This step should prevent the accidental discharge of a patient from your hospital with an IV catheter, or the placement of an unnecessary second IV catheter.

As mentioned above, the emergency doctor will also call or fax you regarding any of your clients’ patients who remain hospitalized at our hospital on weekday mornings for continued care. Prior to referring cases directly from our emergency service to any of our specialists, our goal is to interface first with you regarding your preferences for case management.

Although our emergency doctors will not typically call regarding routine cases or outpatient visits, please do not hesitate to call our hospital if you have any questions about a medical record or management of a case. Our goal is to achieve excellent continuity of care. If at any time you are dissatisfied with our services, please let us know immediately and we will make every effort to solve the problem, satisfy the client, or do whatever it takes to address the issue. We welcome your suggestions for our continued improvement and very much appreciate your support.

We are pleased to offer several types of specialized services for regularly referring hospitals including:

• Reduced Cost “Medical Observation” Hospitalization Rate for Stable Patients.
  Certain stable patients may qualify for a reduced hospitalization rate of $6.00/hour, which includes doctor oversight, technical nursing care, and hospitalization. This service is intended to provide owners of relatively stable patients with a cost-effective option for overnight patient monitoring, thus reducing the inconvenience and liability to your hospital associated with hospitalizing patients overnight or through a weekend.
  
  In order to qualify, the patient must be a direct referral (i.e., already under treatment at your facility on the day of transfer) and considered medically stable based on the judgment of our doctor on duty. Examples of typical “Med Obs” cases include elective post-surgical patients with slow recovery but normal vital parameters, stable post-obstructive non-uremic FLUTD cats, stable resolving gastroenteritis patients, etc. Patients in critical or unstable condition (e.g., seizuring, oxygen dependent, azotemic, oliguric, or other patients requiring close supervision or critical care) do not qualify.
  
  This discounted hospitalization rate does not include ancillary therapeutics or diagnostic tests deemed necessary by the emergency doctor on duty. To protect our own liability, please understand that our emergency doctors are required to offer a care plan that at least meets the “minimum standards of care” of the Veterinary Medical Board. These standards are higher for emergency/critical care facilities than they are for general practices.
• Reduced or “At Cost” Handling of Post-Surgical Complications.
  Within reason, minor post-operative complications will be handled at a reduced charge to minimize fees to your clients. As an extension of your practice, we recognize that minor complications, which may still be very distressing to a client, periodically occur and are best handled quickly and inexpensively.
• STAT Laboratory Tests on Hand-Delivered Samples.
  If you occasionally need immediate results for a critical patient, we can run STAT laboratory tests for you such as chemistry profiles, electrolytes, blood gasses, coagulation parameters, blood typing, ethylene glycol or toxicology screening tests, etc. Please call ahead to arrange for this service and to determine appropriate submission samples.
• Low Cost Outpatient After-Hours Treatment/Testing.
  Based on your prior directions, we will administer most injections or subcutaneous fluids to outpatients on a one-time basis without an emergency/examination fee. Outpatient blood glucose testing or Doppler/Dinamap blood pressure measurement are also available. Please call ahead to arrange for such services.
• Discounted Services for Personal Pets of Doctors or Staff Members of Referring Hospitals.
• Convenient Morning Transport Service From Our Hospital to Yours.
  Upon client request and approval, we are typically able to arrange the transport of a patient by one of our staff members to your hospital on weekday mornings. We charge a nominal fee for this service, which compensates our staff member for his or her time.
• Satisfaction with Our Services.
  We will strive to provide the highest quality of care and the finest services to you and your clients. We welcome your suggestions for our continued improvement and very much appreciate your support. Please contact us should you have any questions or concerns. We will make every effort to solve a problem, satisfy a client, or do whatever it takes to address an issue.