BluePearl- North Seattle (formerly ACCES) ER Closure
About a month ago, my former hospital (ACCES/BluePearl – North Seattle), closed its emergency service due to staffing issues, another victim of the incredible challenges facing the veterinary industry. This closure of a needed (and successful) veterinary emergency facility due to staffing issues was not the first and will not be the last.
I’ve spent the last several weeks pondering what to say about this closure. For a long time, ACCES felt like my child. From 1999, when I first contemplated opening a hospital, until 2017 when I left, I poured my heart and soul into creating something special for pets, pet owners, and for veterinary professionals.
My first drafts of this blog were angry, pointed, and accusing. I don’t believe veterinary emergency medicine needs to be as hard or as frustrating as it is right now. As Don Berwick, an MD from the Institute of Healthcare Improvement, has said, a profession as noble as medicine should be full of joy, not burnout.
However, after much thought, today I want to express gratitude for those people I got to know and what I learned from ACCES.
The ACCES Story
As recently as the late 1990s, there was no 24/7 veterinary care in Seattle. The impetus for me to start ACCES was a dog with tetanus that died because it had to be transported back and forth between our overnight emergency hospital and its primary care clinic. That case was awful for the owners, the dog, the primary care veterinarian, and for me. There had to be a better way. Jean Maixner had similar experiences with cases and was also looking for a solution.
After 4 years of planning, applying for financing, and construction, we finally opened in September 2003. We opened with 12 staff, and were fortunate to be welcomed to the community by pet owners and the primary care veterinary community. Our goal was always to provide the best care possible in an environment focused on a team approach to continuous improvement.
Over 10 years, we grew to 150 staff in two locations, and helped well over 100,000 pets. Just as importantly, we supported many employees in their growth. Veterinary assistants became licensed technicians and technicians became technician specialists. Many staff became veterinarians. One of the veterinary assistants who helped start the practice is now a veterinary critical care specialist. Associates published case reports and large-scale studies. Our practice manager obtained his MBA and our HR manager obtained her SHRM certification. Now, former associates own their own successful practices and more are on the way. In addition, our focus on continuing education training in the community improved the care pets received in all hospitals in the area.
Lessons learned
Opening and running ACCES was one of the hardest things I have ever done. I was tired. I had days I cried from exhaustion. However, it was also one of the most satisfying. In the midst of the discussions around burnout and wellbeing, we have to remember that sometimes joy comes from working incredibly hard on something you are passionate about. Sometimes your best and proudest moments come after you have worked harder than you thought possible to create something special. I see too many people who are afraid to truly admit their dreams and play big.
I also learned working at ACCES how amazing it is to co-create excellence as part of a team, all striving for the same goals. We could never have delivered the type of care we did without open discussion, vigorous debate, constant trial and error, and willingness to admit we were wrong and try something else. Most of the best ideas at ACCES came from our employees.
When we opened ACCES, both my partner and I wanted it to be a legacy practice, one of those places that would still be around in 40 or 50 years, owned by veterinarians. I have spoken in previous blogs about the challenges in today’s market of that vision. My vision for ACCES’ legacy is now different. I hope that ACCES Alumni will bring to all aspects of their professional careers a belief that excellence comes from continuous learning and improvement, teamwork, open communication, and compassion.
So today I just want to say thank you to the ACCES Alumni for being part of something amazing AND continuing to do amazing things.
Epilogue
As many of you know, tetanus is rare. I have not seen many cases since that original one. However, this past month, as BluePearl – North Seattle/ACCES was closing, my new team at WSU was treating another dog with tetanus. This time, we had round the clock care in a quiet well monitored space with input from multiple specialists. After almost 2 weeks, the dog went home and made a fantastic recovery. Better is possible.
6 comments
I strongly believe that the Veterinarian community needs to hear from the pet owners.
I went to a Blue Pearl ER in mid-town Manhattan (New York City) this past June 15 because my dog (Cushing’s patient) was having many weeks (well into the 2d month) of intractable diarrhea. We arrived ca. 7:30 PM in a taxi – which as a low-income, retired, 86-year-old Senior is an outrageous expense I’d hardly grant myself – and my dog was taken inside in about 5 minutes. I had my cell phone fully charged to speak to the ER Vet on duty when she was ready to talk about the dog’s issues.
My dog had an Idexx Chemistry Panel, CBC, and re-hydration. No fecal sample was available. This involved long waits for the dog and for me. Almost four hours later, while I sat in the dark in the rain, in a tent erected for pet owners, I was told, when I asked, that I could NOT use the bathroom. I am a fully vaccinated immunocompromised person but the diuretic I take daily doesn’t stop urination for a dog in an ER. I walked around in the rain trying to find an open business who’d let me use their loo. The wine shop next door to the Vet said okay. The Vet called me on my cell phone. I asked if she could give me an Rx for metronidazole to stop the diarrhea. She agreed that it would be a take-home without my even asking. She said the dog was in decent shape at 13Y 8M, even with the Cushing’s, but she had to be hydrated. I knew my dog was dehydrated from the diarrhea and was glad that the Vet got her fully hydrated.
Then the ER Vet said she’d recommend that I leave my dog overnight to be seen by a “specialist” the next day. Since I had already made an appointment at The Animal Medical Center New York for my dog to be seen by a specialist whose credentials and research publications I checked online, I did not agree to the overnight stay at Blue Pearl. I paid the bill of $797.73 (via VISA CC) and had to find a taxi at 11:30 PM to get us home. I couldn’t carry my dog so we walked very slowly for many blocks until I could find a taxi – and one who’d take a small dog. The taxis round trip added another $36. to the night’s tab.
The next day, I researched the ER Vet who had seen my dog. It turns out that she is a fine Vet whose specialties are avian and exotic pets. Her daytime affiliation is with a Vet practice that does not see dogs or cats – it calls itself “New York City’s only Exclusively Exotic Pet Hospital.” She is a very recent graduate of Cornell University veterinary school and, as far as I could determine, she was filling the role of a locum tenens at this NYC Blue Pearl ER night shift.
The Vet who saw my dog at The AMC is a DACVIM in the Internal Medicine service has about a dozen years of experience along with a recently published paper about a research project on dogs taking trilostane, which my dog has been taking for 2.5 years. Over the last years of doing reading in the medical literature on canine Cushing’s as well as my own health conditions (asplenia, lymphocytosis, et al.), I feel like a fairly knowledgeable civilian (who was once a college biology major.)
Conclusion: The Blue Pearl experience was uneventful and quite expensive. (Yes, that is a real live issue for pet owners in New York City – or any big city.) I didn’t think the Blue Pearl ER Vet had any real experience in dogs with pituitary-dependent HAC nor did she know much more than a basic textbook on the subject. I ran out of the metronidazole quickly – too few tablets given me. I already had several years of caring for a Cushingoid dog. If Vets are having a hard time, consider what some pet owners go through. You are in a profession many of us envy, admire and rely on. But we pay the price … with a bit of complaining, I admit … because we too are dedicated to the same animals that you are. Thank you.
Ms Wasserman, Thank you for your comments. I absolutely agree that the curbside care veterinarians have had to offer clients during this pandemic has been not ideal for anyone. We are all looking forward to the next months, where as vaccination rates rise, we can start having clients wait in more comfortable conditions. I do think the costs for emergency veterinary care are high and at the same time most veterinary staff still do not make a true living wage. In many ways, the economics of veterinary medicine is broken and needs solutions.
I don’t even know where to begin. Thank you so much for so many wonderful years. I appreciate you more than you’ll ever know. I wish I could’ve recorded all the nice things people have said these past few. I’m so SO sorry about this.
Thanks for all you did for the communities of the veterinary family and of the greater Puget Sound region.
You’ve been on my mind since this news.
Before its move to the new facility, the staff of this hospital saved my senior pug via emergency surgery. I was blown away by the excellent care and compassion given to me and to my dog during this most stressful time. I am forever grateful. What a deep loss for our community. Tragic, really.
My business, Precious Pets Animal
Crematory, worked with your Renton facility for the last 11 years. We started there when it was Access. We loved the staff and the environment there. We watched everything change very slowly once Blue Pearl took over. The staff morale was the biggest change we noticed. It is unfortunate that these big corporations are taking over and not caring for their employees with the same care and empathy that their own employees show the pet’s and their owners. We no longer work with Blue Pearl Renton since a new manager came in and broke a contract with us. Every staff member there wanted to keep our services but corporate chose another corporate company to work with. In the end, I miss all of the great people we worked with there and hope that Blue Pearl will one day treat their employees better. You did a great thing with Access and that will always be remembered by the wonderful employees you paved the way for. Thank you.