Policies

These are my general thoughts, musings and feelings on how I best work.  I have not seen every way of practicing and I try to keep an open mind about "best practices".  There are some techniques that may not be considered gold standard that work well in my hands and others that simply don't.  Some of these I may be flexible on and others I'm a bit of a stickler about.  Just call me and we can discuss.

1. Commitment to Professionalism

This should go without saying, but I’ll say it anyway:  You can expect high standards of professionalism from me.  While I’m on the clock at your clinic, I will work diligently on your clinic’s tasks only.  I will not hang out on my cell phone or browse the internet.  I will not work on cases from another clinic.  I will not discuss your clinic’s policies with other clinics and vice versa.  I will treat your staff and clients with respect and as if my ongoing, not just short-term, livelihood depends on it. 

I do feel it is reasonable to take a couple of 10-minute mental breathers/snack breaks throughout the day.

2. Continuity of Care

While I have my own preferences in medicine, if there is no or little difference in your treatment protocol and my preferred protocol, I will follow your clinic protocols to allow your staff and clients to feel as though my addition to your clinic is as seamless as possible.  I will rely on your written protocols and listen to your staff to learn what is normal for your clinic.

3. Licenses, Insurance, Certification, etc

I maintain the following licenses at my expense:

  • Montana Veterinary License:  13701

  • Professional Liability Insurance through AVMA.  Certificate:  VETPRO038007

  • DEA license.

  • My state of Montana USDA certification training to write health certificates should take place in June of 2021.  Until then, I am not authorized to write health certificates.

4. Species

I strongly prefer to practice on canines and felines only.  I do have experience treating small mammals and reptiles and will consider seeing them on a very limited basis only if we discuss this beforehand.

5. Dress

Please let me know what to wear.  I can adhere to the dress code of most clinics and can wear a large name tag for the benefit of your staff and clients.

6. Downtime

Of course, I will work on emergencies, then scheduled appointments first.  After that, I welcome other tasks from you!  I work in the following order:

 

  • Address any emergencies

  • Work on assigned appointments or surgeries, completing records as I go.

  • Offer to help colleagues.

  • Make client phone calls and approve prescription refill requests.

  • Work on downtime projects that you may dictate.  I can write time-saving templates for common cases, help with staff training, research the latest information on a medical topic that has been bothering you or other tasks.

Staff training topics I particularly enjoy are ophthalmology, interventional dentistry, client communication, vaccine protocols, Canine Infectious Respiratory Disease.

  • If you like, I can have the staff call pets with overdue reminders to book appointments if there is still downtime (I find this is rare)

  • Read veterinary topics and complete online CE.

7. Callbacks

I will perform callbacks to clients with their labwork results or regarding client questions after and between scheduled appointments as much as possible.  I will not be available to call clients back on days that I am not scheduled with you.  I aim to leave clear records for all cases that I see but especially for cases with pending labwork.  If there are any questions, you may call me directly and I can clarify my thoughts on the case to you or your doctors.  Please be aware I will not answer my phone if I am on the clock at another clinic and will extend the same courtesy to you.

8. Length of appointments

I do not have a minimum length of appointment because every clinic is different.  However, if your appointments are on the shorter side or your clinic does not have the ability to run multiple rooms at a time, it is reasonable to consider lengthening any relief veterinarian’s appointments relative to what you allot your associates.  Remember that your associates have the advantage of mastering your computer system, memorizing prices to give quotes on the fly, knowing what drugs you have on hand, and having a relationship with your staff and clients to help them move through appointments more efficiently than a relief veterinarian can. 

9. Surgery

I enjoy surgery and am comfortable with many common soft tissue procedures as I have listed below.  That being said, it is fair to tell you that although I am an experienced and competent surgeon, I work at a slower pace than average. 

 

Before scheduling me for a surgery shift, it is best if I work at your practice seeing appointments for at least one shift so I can familiarize myself with your staff, equipment, inventory and workflow and you can meet and become comfortable with me.  If you really want to book a surgery shift on the first day, we can discuss that over the phone. 

 

Although I have my own requirements and preferred protocols listed here relating to surgery and anesthesia, I welcome learning about others’ techniques.

 

I require the following for surgery:

  • An anesthesia technician must be present during the entire procedure with no other obligations

  • Gas anesthesia machines in excellent working order

  • No mask-downs

  • Pre-operative bloodwork

  • IV catheters and endotracheal intubation for all surgeries except feline neuters

  • For premedication, I require any opioid plus either dexmedetomidine or a benzodiazepine

  • For induction, I require either propofol or ketamine/benzodiazepine

  • A dedicated operating room

  • Patients monitored closely in the post-operative period

 

Surgeries I can provide:

 

Routine Surgeries:

  • Spay

  • Neuter

  • Mass removals

  • Cystotomy

  • Splenectomy

  • Anal sacculectomy

  • Enucleation

  • Nictitans replacements (Morgan pocket technique)

  • Basic entropion correction 

  • Aural hematoma repairs

  • Nares and palate alterations are one of my favorite surgeries.  They make such a difference in the life of brachycephalics.  I perform a small wedge resection which results in excellent aesthetics.  Please note:  a CO2 laser is required for this procedure. 

 

Laparoscopic Procedures:

  • Spay

  • Cryptorchid neuter

  • Liver biopsy

  • Gastropexy

 

Emergency Procedures:

  • GDV detorsion surgery and gastropexy

  • Gastrotomy/enterotomy/intestinal resection and anastomosis

  • Pyometra surgery with spay

  •  Caesarian section with spay

 

Orthopedic procedures:

  • The only orthopedic procedure I offer is amputation for clients who refuse referral for repair

 

Oral surgery:

  • I am not performing dental procedures/COHATs/oral surgery at this time due to a pregnancy to avoid being exposed to waste anesthetic gas but look forward to doing so in the future

  • I have received training from Dr. Tony Woodward in dentistry and am capable of all aspects of a COHAT including full mouth radiographs, scaling and polishing (though I prefer to have a technician do this portion), bonding and sealing teeth and surgical extraction

  • I also have experience placing incline planes for dogs with base narrow canines (an underdiagnosed problem) as in this article www.toothvet.ca/PDFfiles/malocclusions.pdf in figure 14

  • I do NOT perform root canals

 

Surgeries I do NOT provide:

  • Declaws

  • Tail, dewclaw or ear amputations

  • Fracture repairs

10. Booking

Simply call or email to book.  Bookings will be confirmed in an email.  Once the confirmation email is sent, the booking is considered finalized and cancellation fees will apply if the booking is cancelled. 

12. Cancellation Policy

Cancellations require that you contact and receive acknowledgment from Dr. Toyne.  Cancellations incur the following fees:

>30 days   -   NO fee

7-30 days  -   25% of the original booking fee

<7 days     -   75% of the original booking fee

 

Weather cancellations:  There are NO cancellation fees for cancelling due to severe weather or dangerous roads.  I will do my best to reach your clinic if you wish to open during inclement weather but please understand if I feel the need to cancel for safety. 

COVID cancellations:  There are NO cancellation fees for cancelling if you feel there is a COVID risk.  If you have any staff members that have symptoms or a positive or pending test, or a known exposure, PLEASE tell me.  I won’t cancel for every exposure situation but I should be able to make an informed decision on what risk I am willing to take.  Likewise, I will communicate to you if I have any symptoms or known exposure.

13. Rates

Regular rates:

General Practice weekday     -   $80/hr

General Practice weekend     -   $100/hr

Emergency Practice              -   $100/hr

The above rates are for up to 10 hours in GP and up to 12 hours in ER.  Anything beyond this goes into overtime.

 

Overtime rates:

At the end of the scheduled shift, I allow a 15-minute grace period for minor unforeseen issues where I continue to charge my regular rate.  After that, I charge overtime for 2 hours – overtime is 1.5x the regular rate.  Any work beyond two hours after my scheduled departure time, is charged double overtime – double overtime is 3x the regular rate. 

 

Overtime situations can arise not only if a last-minute emergency arrives close to closing time, but also if adequate time is not allotted for regular duties.  Please decide in advance how you would like to handle overtime situations.  Some clinics notify their front desk not to allow any late afternoon “work-ins” or last-minute appointments after a certain time.  Other clinics appoint a staff member to decide based on the individual situation and client.