The Dedicated Ophthalmology Referral Practice

Veterinary Business Journal August 2003

The following article appeared in the Veterinary Business Journal in August 2003. It described the process by which the eye hospital came to be and the hurdles overcome to achieve it. This article is reproduced by kind permission of Veterinary Business Development Ltd.

Interest in ophthalmology leads to single-discipline referral practice

The VBJ visits a specialist ophthalmology referral practice in Herefordshire which is capitalising on a geographical marketing opportunity and handling cases from far and wide in its new and versatile premises.

“NOMINATIVE DETERMINISM” was the name given by New Scientist magazine to the phenomenon in which a person’s family name can mysteriously influence his or her professional interests.

The term was coined after the publication of a paper in the British Journal of Urology by Dr J. W. Splatt and Dr D. Weedon on the treatment of incontinence.

Readers of the magazine’s Feedback diary unearthed many more examples of scientists with satisfyingly appropriate research interests before its editors eventually decided that enough was enough.

Yet at no time was it realized by contributors to one of the column’s longest running threads that the phenomenon also applies to geographical entities.

How else could one explain the fact that the UK’s first ever single-discipline veterinary referral practice - dealing exclusively with ophthalmology cases - should be established in Eye, near the Herefordshire market town of Leominster.

The practice principal, Paul Evans, could hardly have foreseen such a long-term marketing opportunity when he set up his plate there in 1973, five years after qualifying from the Cambridge veterinary school.

Although he had already developed a passion for eye surgery cases through the influence of his university mentor, Dr Keith Barnett, it was old-fashioned mixed practice that would occupy his time for the next 18 years.

The staff (from left): Jo Sharp, receptionist/administration; Paul Evans, principal; Esther Smith, VN; Izak Venter, visiting veterinary ophthalmologist from South Africa; Jo Wall, head nurse; Julie Carpenter, nursing assistant; Eileen Davies, practice manager; Nicola Fisher, receptionist.

But throughout the long working hours spent as a single-handed practitioner, Paul able to maintain and develop his interest in ophthalmology. In 1984 he was ready to take his RCVS certificate and by the end of the decade his trickle of referred cases was turning into a regular stream.

“At one stage the turnover from referral work was doubling every quarter and I remember hearing at a management symposium that once your income from a particular area approaches 50 per cent of the total, you should consider making it a full-time career,” he explains.

So in 1991 he sold his first opinion client list to a neighbouring practice and set up the Eye Veterinary Clinic.

The reception desk (above) and waiting area (left)

For the next decade, Paul concentrated on honing the skills that would establish his reputation as one of the finest veterinary ophthalmologists in Europe - a status that was formally acknowledged by his peers when he was named president-elect of the European Society of Veterinary Ophthalmology at its meeting in Cambridge in June.

Meanwhile, in a familiar story, the growth in the practice caseload was putting increasing pressure on the clinical facilities at his family home. There was a shortage of parking space and the old agricultural buildings in which he was working were never an ideal site for such high-tech activity.

Given the long distances travelled by its clients, the best location for the new premises would have been somewhere much closer to the motorway network, perhaps near the junction of the M5 and M50 between Worcester and Gloucester.

Paul, however, was unhappy about the prospect of uprooting the practice too far from its established base. “In this job your staff is at least half your business. By moving so far away we would probably have found that we would be starting from scratch with entirely new support staff,” he says.

In any case, Paul does not believe that clients who are sufficiently well-motivated to seek the services of his clinical team would be put off by the extra journey from the motorway.

A dog being prepared for cataract surgery

Moreover, there is a further option for any clients living near the M5 axis who do not have their own transport.

Paul and his colleagues, Lorna Newman and Emma Hayton-Lee, take monthly surgeries at first opinion practices in Stroud, Bristol and Dursley to the south, and in Wolverhampton to the north.

Paul would like to provide more frequent surgeries at these satellite centres in order to give better continuity of care, but significant expansion will require strengthening the existing clinical team.

The perfect site

Long ago, Paul had spotted what he was sure was the perfect site

Continued on page 2

THE PRACTICE

EYE VETERINARY CLINIC
The Eye Hospital for Animals
Marlbrook
Leominster
Herefordshire HR6 0PH

Established: 1991, new premises opened April 2002

Staff: three veterinary surgeons, two veterinary nurses, one nursing assistant, two receptionists and practice manager

Premises: ground floor 336 sq. m., first floor 164 sq. m.

Turnover: 100 per cent ophthalmology referral cases

Time allowed for initial consultations: 30 minutes

Initial consultation fee: £80 (including VAT)

Average transaction fee: £90 (includes submissions to lower value scale fees examinations for BVA/KC eye scheme); average fee for surgical cases £470

The electroretinography kit in use on a Bassett hound