Arrow Animal Urgent Care – a new model for a new time
With demand for veterinary services exploding in Puget Sound, two veterinary school classmates opted to take the plunge and start a new 7 day a week urgent care hospital. Their veterinary hospital, Arrow Animal Urgent Care, opened in January in Renton, Washington and is providing much needed walk-in, urgent care services for dogs and cats. Here is their story.
The Need for Urgent Care
Deep in the Pandemic, longtime friends and veterinary school classmates, Drs. Beth Guerra and Laurie Wieringa, began talking about opening a hospital. They had previously said that they would never own a hospital. However, they were frustrated by what they were experiencing in the profession. Wait times for clients were long, staff were frustrated working for remote ownership, and veterinary colleagues felt unappreciated and overworked.
Both Guerra and Wieringa had deep experience in emergency veterinary medicine and had worked in different area multispecialty hospitals. They both enjoyed the fast pace and challenge of emergency cases but did not want to do ICU medicine. They had also both done primary care but most enjoyed the more urgent complaints. While working emergency, Guerra felt increasing empathy for clients who couldn’t get into their primary care vet for an urgent problem and then waited long hours at the ER. Wieringa was frustrated that her primary care practice couldn’t fit more into their schedule and also could not get patients seen on emergency. Together, Guerra and Wieringa felt they could put together an option in the middle to better serve pets and their people.
The Vision
Their vision was a walk-in only hospital, open every day of the week, but only during prime hours. The hospital would not do major surgery, would not do preventative care, and would not hospitalize pets. It would help treat conditions such as ear infections, urinary tract infections, minor wounds, minor intestinal upset and early toxin ingestion. By serving this niche, they could provide a service that would help pets and owners and also relieve some of the burden from both primary care practices and emergency services.
The start-up process
Solidifying their vision was the first step. Which minor procedures would they do? Would they send out any laboratory work? What were the right hours to be open to serve this need? Through many brainstorming sessions, they clarified their niche and services.
Once they knew where they were headed, they looked for financing and were able to find support through Bank of America’s veterinary practice division. A location was the next step and after clearly identifying the borders of both of their non-compete provisions, they started the search. Through serendipity, a listserv email alerted them to a veterinary hospital location that was coming available. The connection proved to be a win-win for the partnership and for the previous veterinarian who was ready to move on.
Because it was previously a veterinary hospital, construction costs were lower than they might have been otherwise. However, permit, inflation, and supply chain issues still added cost and some delays.
Staffing was set to be the next big challenge. However, the support and kindness Guerra and Wieringa had provided to the staff they had worked with in multiple locations paid off. They were fully staffed with competent, enthusiastic team members for opening.
Opening Arrow Animal Urgent Care to meet demand
After 15 months of planning and construction, Arrow Animal Urgent Care opened in late January. There were 10 patients waiting for them when they opened their door. The first day was the slowest and the hospital has consistently helped 15-30 animals each day. They have had people come from as far south as Olympia and from as far north as Arlington, thankful for someone available to treat their pet. The original plan was for Drs. Guerra and Wieringa to be the only veterinarians for the practice in the first year. However, within 2 months, they were looking for help.
Looking for Efficiencies
The way to be successful in urgent care is with highly efficient work flows. Guerra and Wieringa opted to go with Instinct EMR* and have quickly optimized it using programmed snippets for medications and discharges. They have simplified their charging structure as much as possible and have kept their inventory low. In addition, they have opted to only do in house laboratory work and to leave further send out diagnostics to the primary care veterinarian.
Empowering Staff
In addition, they have empowered their staff to suggest, change, contribute, and help them build the optimal processes to make the hospital successful. Their staff helped them visit primary care hospitals to market Arrow Animal Urgent Care. They helped build daily checklists, have suggested ways to improve inventory storage, and have worked on other ways to help keep cases moving. The continual input and ideas have allowed Guerra and Wieringa to accomplish much in a short period of time.
Advice for others
The pair’s biggest advice for others opening a hospital would be to let people help you. Veterinarians are a self-reliant, independent group but opening a clinic successfully takes a village. Ask for help and gratefully receive assistance from all who offer. Many people provided assistance to Arrow Animal Urgent Care, from business advice to actual construction, that helped move their project forward.
One thing they wished for during the start up process was a really detailed checklist. So, for other would-be veterinary entrepreneurs, here is our first stab at a veterinary clinic startup checklist. Comment or email me to add suggestions and improvements to the checklist!
While it has been exhausting, Beth and Laurie are glad they took the plunge. It has been gratifying to be able to say “yes” and help the pets and clients who need them in Puget Sound.
The Veterinary Clinic Start Up Checklist
- What is your vision? Your why? Write it down.
- What services will you provide to fulfill your vision? Are they all truly necessary? What will be a distraction and should be avoided?
- Decide where you want to be (general location)
- Make a business plan
- Start the financing search/pre-approval process
- Decide the type and start an entity (LLC and S Corp are most common for veterinary hospitals)
- Get a Federal EIN
- If you have partners, find an attorney to help you craft your partnership agreement
- Open a bank account
- Logo
- Website and IT support
- Look for a specific location
- Lease or purchase agreement
- Insurance – building, business, key person life, business interruption, health insurance
- Hire an architect (some will do this prior to location to have a better idea of size)
- Interview contractors
- Solidify your equipment list
- Talk with a distributor about inventory
- Choose an EMR system
- Investigate options for radiology – CAREFUL with contracts
- Investigate options for laboratory (inside and outside) – CAREFUL with contracts
- Remember state and local permits
- Write job descriptions and decide what roles you need to hire
- Decide on your pay structure and benefits plan
- Create an employee handbook
- Advertise for staff
- Interview for staff
- Radiology badges
*In full disclosure, I am a minor shareholder in Instinct.
