Horse & Buggy MedCare (aka H&B) is Coldwater Junction’s answer to the return of local medical care. It serves as an urgent care facility as well as a general practice. The practice was created by a group of medical specialists with various areas of expertise. The goal was to provide Coldwater Junction and rural Flathead County with excellent healthcare in a form and format suitable to the region.
The practice’s management structure has been flattened to better serve the public. Horse & Buggy is a group of equal partners who all share financial and management responsibility. In recent years, they have hired a Chief Executive Officer to actually manage the business part of the organization since it has to make a certain amount of money in order to stay in business.
Each new partner undergoes a strenuous and thorough background check before being given a buy-in dollar amount. The buy-in to the practice is based on the individual’s past income and an estimate on future income generation. It is never an exhorbitant amount as the goal of the group is to make sure new partners are invested in the practice.
Horse and Buggy extends the same stringent requirements to the DVMs that they add to their consortium of human and animal healthcare.
Most of the doctors have other full time practices or hospital associations. H&B is open 24/7/365 for urgent care, but closed for general practice on major holidays. The doctors, nurses, nurse practitioners, and physician assistants all share the on-call duties and cover for one another in the event of illness, personal emergencies, days off, or other work related issues. The partners all rotate on-call duties and each doctor has to maintain privileges at local hospitals.
The clinic in downtown Coldwater Junction operates a twenty-four hour call center staffed by professional medical personnel. The partners all have to work at least one day a month at the switchboard. Partners have some discretion on office hours, but they do have to be available on the premises at least two days a week.
Making house calls is the mainstay of Horse & Buggy and is the basis of their operation. The practice was initially formed in order to reach those that might not be able to go to a doctor’s office, clinic or hospital. The house call operation is also the practice’s biggest outgoing expense as they have to maintain a fleet of medical vehicles. They also have to maintain major malpractice insurance coverage.
Horse & Buggy MedCare maintains a clinic in downtown Coldwater Junction. It includes several doctors’ offices, exam rooms, x-ray equipment, and a small operating room for minor emergency surgeries (patients would be immediately transported to a hospital in Kalispell for longer term treatment).
Mobile Medical Services
H&B maintains a fleet of mobile doctor’s offices. These range in size from large SUVs to ambulance / EMT type vehicles. The larger vehicles can transport patients and provide a sterile treatment room for doctors doing house calls.
Since animal companions and livestock plays a major role in the lives of the residents of Flathead County, Horse and Buggy has contracted with several verterinarians. The DVM services are included in their on-call arrangement. The service works the same as the medical services with the DVMs rotating on-call duty so that there is always coverage for animal related emergencies.
Unlike the medical side of the operation, the animal care operations use several privately owned clinics. This is due to the fact that different types of animals requires different types of care. It also removes contamination and sanitation concerns from the medical clinics.