I’m fortunate to live in a wealthy, horse-filled area that can support a variety of options. We have multiple vets - both 100% ambulatory, and those with both clinic and ambulatory practice. At least 6 are within the coverage radius of my barn. We also have a few specialists who visit the area on a regular schedule, including an ophthalmologist, a few eastern medicine practitioners, and a few performance horse management specialists.
I use a large clinic with both ambulatory and hospital practice. The farm call fee is basically the same as the hospital visit fee. I’ve only trailered in when necessary - surgery, higher quality scope, higher quality pelvic x-rays, etc. Happily, they let you choose which vet you want to see for all scheduled visits. For emergencies during business hours, they’ll get you “your” vet if possible. For all other emergencies, you get whomever is on call.