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For most of his career, Dr Ian Douglas of NeuroVet in Adelaide has run referral-only practices. He wouldn’t have it any other way. By Kerryn Ramsey
While working in a general veterinary practice in 1991, having previously undertaken postgraduate surgical training at the University of Melbourne, Dr Ian Douglas realised that South Australia needed at least one small animal surgical referral practice. He decided to jump in the deep end and opened Veterinary Surgical Referrals in Birdwood, South Australia’s first referral-only surgical service. The big issue with this type of practice is that you are reliant on other vets to channel work to your business. You’re not the local vet and there is no walk-in trade.
“It’s a matter of communicating with veterinary practices and developing a relationship with them,” says Dr Douglas. “It’s a slow process, no matter how much enthusiasm you have. I spent much time discussing cases with vets over the phone. It takes several years to build a reputation.”
Over the next nine years, the practice gradually grew, and vets were regularly utilising the skills of Dr Douglas. He found the work enjoyable and the referral-only concept was very appealing.
“I’m fairly obsessive when it comes to the work I do,” he says. “But with surgery, you have to be relaxed and not take on too heavy a caseload. The referral-only business model suited me very well.”
In 2000, Dr Douglas moved to Adelaide to open the Adelaide Veterinary Specialist & Referral Centre (AVSARC) with then business partner, Dr Tony Read, a specialist veterinary ophthalmologist. Dr Douglas had a growing interest in neurology and was able to pursue that field due to some savvy hiring.
“At AVSARC, we took on a surgeon who was a specialist in small animal orthopaedics,” says Dr Douglas. “Then we engaged a soft tissue surgeon and I was able to concentrate more on neurology and neurosurgery.”
Vets Beyond Borders
Dr Douglas was elected the inaugural president of Vets Beyond Borders (VBB) in 2005. He sits on the board today and is chair of the programs committee. In 2006, he headed to the Indian state of Sikkim to help establish the Sikkim Anti Rabies & Animal Health (SARAH) program, the first state-based anti-rabies and animal birth control program in India. Thanks to the support of Brigitte Bardot’s foundation and the Sikkimese government, to date nearly 75,000 animals have been sterilised and 300,000 doses of anti-rabies vaccine have been administered to animals in the state.
“Training of local veterinarians is integral to any animal birth control and anti-rabies project,” says Dr Douglas.
Stemming from the SARAH program, Dr Douglas helped set up VBB’s VetTrain program, to develop local surgical skills. Since its launch in 2009, hundreds of vets, veterinary nurses and humane animal handlers have completed VetTrain courses in India and several other countries in the region.
“Ian has been instrumental to the success of VetTrain and the model is highly regarded,” says Dr Sally Colgan, CEO of VBB. “It has been adopted by other organisations active in India and the Asia-Pacific region, increasing the impact and reach of this initiative. Since leading the pilot program in Delhi in 2009, Ian has continued to inspire experts from all disciplines within the profession to contribute to this fabulous initiative. He has engaged members and fellows of the Australian and New Zealand College of Veterinary Scientists, specialist colleges and veterinary associations in the UK, Europe and USA to join with Vets Beyond Borders in support of our partner organisations. The achievements of VetTrain can be attributed to the passion and dedication of Dr Douglas.”
VBB aims to see the model widely rolled out across the Asia-Pacific regions once COVID-19 travel restrictions lift. Discussions are already underway and 2022 is looking promising for VetTrain’s recommencement.
Dr Douglas graduated from the Royal (Dick) School of Veterinary Studies at the University of Edinburgh in 1974. He had only worked as a locum for a few weeks before deciding to travel to the other side of the world.
“Australia seemed like paradise for a young man and I wanted to see the world,” he says. “I registered with an agency who told me I would have my choice of jobs when I arrived. Strangely, when I arrived in Perth, there were no jobs available. I worked as a cook and on a sailing ship before finding a job in a general practice in Melbourne.”
Dr Douglas planned on being an equine vet back then and with all the confidence of a recently graduated 22-year-old, rang the University of Melbourne in response to an advertisement for the position of lecturer in equine surgery. Unsurprisingly, he was not appointed.
“As my working holiday visa was about to expire, I headed back to the UK with my tail between my legs,” he recalls. “However, some time later, I received a phone call from Dr Tony Mason, then head of the surgery department at Melbourne University Veterinary School. He said, ‘We remember your application—with some amusement.’ But he had rung to offer me an internship in surgery, and that meant I could obtain a permanent resident visa. I gladly accepted Tony’s offer and returned to Australia. When I eventually left Melbourne, I worked in predominantly mixed practices around the country, finally settling in South Australia in 1981.”
In 2010, having sold his share in AVSARC several years previously, Dr Douglas was contacted by a colleague who ran a surgical research facility at Flinders University. They had installed an MRI unit that was only intermittently used. Would Dr Douglas be interested in making use of this facility?
“Five minutes later, I was down there, discussing how I could be involved,” says Dr Douglas. “MRI is the gold standard when imaging of neurological cases is required.”
In 2013, Dr Douglas established NeuroVet, a dedicated veterinary neurology and neurosurgical service, the only such clinic in South Australia. It is still based at the MRI facility at Flinders University.
“Neurology is an unforgiving discipline,” says Dr Douglas. “Firstly, you have to ascertain whether the case is actually a neurological problem. Then you have to come to an anatomic diagnosis. Is it in the central or peripheral nervous system? Whether it’s the brain or the spinal cord, you need to know the specific area of interest before going anywhere near an MRI.”
A recent patient was a dog with vision loss. The owner was referred to an ophthalmologist who didn’t think it was an eye problem. He referred the case to Dr Douglas who suspected intracranial disease.
“We scanned the dog and defined a four-millimetre diameter tumour next to the base of the pituitary, in the region of the optic chiasm,” says Dr Douglas. “It wasn’t great news for the dog, but there’s a satisfaction in doing the work and identifying the problem.”
Dr Douglas has run referral-only practices for most of his career. This type of business offers a unique set of challenges that are not faced by general veterinary practices. Your business succeeds or fails on the number of referrals it receives. Do you cast your net wide or have a more targeted approach?
“When I was firing on all cylinders, I took on a wide range of cases,” says Dr Douglas. “Nowadays, I don’t deal with emergencies or perform surgery; I’m focused on diagnostics. My case load is reducing over time because I’m 69 and creeping up on retirement, though that’s not going to happen in the near future. I’m at an age where I can concentrate on what I really enjoy.”
Dr Douglas believes it is now much more difficult for an individual practitioner to set up a referral-only practice—but it’s not impossible.
“It’s a field that’s more or less monopolised by corporates,” he says. “They have a lot more capital behind them and are able to purchase all the required equipment. But if you have a specific interest and relevant post-graduate training—and you’re happy to work 10 days a week—it can still be done. Clients tend to respond positively when they come to NeuroVet. Personalised service should never be undervalued.”