22 Oct 2024
Orthopaedic Vet near Derby was founded less than a year ago by two experienced surgeons who wanted to branch out on their own. But has their decision to enter the highly competitive referral market paid off or have principal owners Karl Underhill and Bart Hendrickx gone out on a limb? VBJ paid a visit to find out…
There cannot be many veterinary practices in the country that can boast such a lovely location as Orthopaedic Vet in Ashbourne.
Completed at the end of 2023 and opened for business at the start of this year, the building sits on the outskirts of the village in the heart of the Derbyshire Dales.
With a beautiful backdrop of rolling hills and tree-filled valleys, it is a beautiful spot, but this is no bucolic backwater despite the verdant vistas.
Some of central England’s biggest urban areas lie within easy reach, with Derby, Nottingham, Sheffield and Birmingham all less than a 45-minute drive away. It was not just the location that was perfect for Karl, Bart and junior partner Aimee Jenkinson, however; it was the timing. Because, despite both working in the region for many years – Bart as a referral surgeon and Karl as owner and lead surgeon at a first opinion practice in Derby – it was not until Karl sold his practice and began looking for new opportunities that the like-minded pair became acquainted.
Karl said: “I qualified as a vet in 2007 from the RVC and pretty much straight away realised that I loved small animal surgery, but in the end, I decided that working in practice and working towards a certificate by getting hands-on experience that way was more suitable for me.
“I started working for a local practice in Derby, and when the owner retired, I bought her out and spent the next 10 years growing the practice. But every single day that I was going into work and I had more complicated surgery to do, I was hugely excited, and the other more routine things were, kind of, less stimulating for me.
“So, when I sold the practice [to Medivet], I knew I wanted to do something that would allow me to operate every day, and it was then that I came across my now business partner, Bart.
“We got introduced to each other by a mutual friend who realised we both had similar ambitions to start businesses focused mainly on small animal orthopaedics, but also soft tissue surgery as well; the timing was perfect for us both.”
Shortly after this well-timed introduction, another came when a long-term colleague, Aimee, stepped into the equation. Bart and Aimee had worked together previously, and Bart was keen to involve the experienced referral nurse, who was soon invited to join the project, not just as a member of the team at Orthopaedic Vet, but an investor.
With the dream team in place, the search began to find a suitable site for the middle-tier soft tissue and orthopaedic referral practice the trio hoped to get off the ground.
Karl and Bart are both surgical certificate holders, rather than boarded specialists, and the plan was to attract clients by offering an outstanding orthopaedic and soft tissue service at a fair price.
But that did not mean cutting corners. Despite plans to keep prices close to the bone, gold-standard customer service and patient care were also a huge priority, which meant a high-spec build would be required.
And it did not take long to find the perfect site: a new 5,000 sq ft building proved to be the perfect blank canvas, while a large car park and great visibility from the nearby A52 ticked two other important boxes.
Karl said: “We felt really, really lucky to get this site, and while it was probably slightly bigger and slightly more expensive than would have been perfect for a fledgling business, it is big enough for us to expand and not have to worry about moving.
“So, it had room for growth and it was an empty shell that we could completely design and do what we wanted with, which was perfect.”
Having found the perfect spot for their venture, the team negotiated a 10-year extendable lease with the landlord and worked with a local architect to turn their blank canvas into their dream practice.
One or two issues delayed the build, but all work was completed in December 2023, with the entire project costing £1.1 million to get over the line.
It is a lot of money, but Karl, Bart and Aimee feel they have got plenty of bang for their bucks, and it is hard to disagree.
First impressions are good; visitors enter a large open-plan reception area with separate waiting zones for dog and cat owners, with four large consult rooms and two offices feeding off the central space.
Moving into the clinical areas, everything you would expect from a facility of this type can be found, with high-end finishes everywhere, from the dog kennels and cat wards to the two roomy and suitably equipped operating theatres that serve as the engine room of the business.
The practice is well-lit by natural sunlight throughout, which amplifies the feeling of space in a building that also offers plenty of scope for expansion, with the first floor currently not in regular use. Elsewhere on the ground floor, a large room has been fitted out ready for the installation of a CT scanner that is expected to arrive in the coming months.
It is a big investment, and Karl admits that an element of risk exists in opening a business like theirs at a time when concerns are growing that revenues are beginning to flag across the referral sector.
He said: “Yeah, I think it’s definitely a risk for a lot of reasons, not least that it is such a competitive market these days.
“But we just felt that we could, judging from our previous experience, provide a very, very high standard of personalised service with excellent communication and use a business model that allows us to perform many orthopaedic and soft tissue procedures cost effectively.
“So, this kind of economic climate in a way, suits us because if there are clients that are uninsured, or their premiums only cover up to a certain amount, then that would be a perfect instance to come to us.”
A quick look at the Orthopaedic Vet fixed price shows just how competitive the fee structure is, with a tibial plateau levelling osteotomy for a 20kg dog costing £2,600, and brachycephalic obstructive airway syndrome surgery coming in at £1,800 – including x-rays.
Karl said: “We’ve already got quite a lot of vets referring to us locally and we have had people come from much further afield.
“In a way, we’re fortunate that the part of veterinary medicine that we really love, me and Bart and Aimee, is also one of the more lucrative parts, and our profit margins on a surgery are greater than they are on a lot of first opinion work like flea treatments, vaccinations and so on. So, for us, that means we are able to be very fair with our pricing.”
Aimee added: “I think the fixed pricing helps where everything’s included – bloods, x-rays, et cetera; there’s no further charge.
“And, as we like to see patients back regularly, the follow-up appointments are not charged either, and so far, it is going very well and we’re very busy.
“We opened in December, but that month was largely spent on a big marketing offensive to let everyone know we are here and while January was a little slow, we’ve been building month to month since then.”
With Karl usually working on-site and Bart handling the bulk of the mobile surgeries, the practice has the capacity to perform three surgeries a day, a level that means Aimee and her nursing team are able to provide the high levels of care required.
She said: “We wanted to put a real focus on not just patient care, but also the way we dealt with our clients. This is why we don’t want to grow too fast; we want all our clients to experience the very highest level of service. That is the central pillar of our business, really.
“We just try to tailor the experience to each patient and each client, and make sure they have all the information they might want at every stage of the process, so that it is a positive experience.”
So far, being practice owners has been a positive experience for Karl, Bart and Aimee, with Orthopaedic Vet turning its first profit in June after less than seven months in business.
Client numbers are also increasing and the workload is manageable for the team, which consists of the three owners, plus four vet nurses and two reception and support staff.
And while the region already boasts some well-established referral centres, Karl believes there should be room for everyone.
He said: “There will be limitations and we’re not specialists, so occasionally, we will need to do a tertiary referral and send things on to a boarded specialist.
“I think as long as you’re aware of your abilities and your skill sets, then I think there’s plenty of room for specialists and there’s plenty of room for advanced practitioners.”
For Karl and Bart, plenty of room is available for expanding their service, with both surgeons committed to improving their own skills and offering new services to clients.
Karl said: “We appreciate that a significant component of being an orthopaedic practice is that we need to be able to help dogs with elbow dysplasia, and arthroscopy is the gold standard treatment at the moment.
“So, for example, Bart is doing a total hip replacement course soon so, at some stage, we hope to be able to offer total hip replacements, and I’ve already done a four-day arthroscopy course in Germany.
“We have the CT machine coming soon and we are really looking forward to being able to offer more services in the near future.”
However, the team has no plans to increase the service offering of the practice beyond its current soft tissue/orthopaedic remit.
Karl said: “We will grow, but it is always going to be surgically based, as we recognise that orthopaedics get referred more than soft tissue cases, so that’s why we kind of use the name, hopefully to our advantage.
“It’s very easy to remember, but at the same time, we want referring practices to realise that we offer soft tissue services, as well.”
Karl added: “In time as we develop, we would like to take on extra vets, which might broaden the service offering, and who knows? In time, we might open another site, as it’s a strong brand with the potential to grow.
“But whatever happens in the future, our focus will always be on offering the best care and the best customer service at a fair price.”
