Satellite clinics might be key to a veterinary school's vitality
and its continued ability to expose students to a broad range of cases, reports
Dr. Michael Kotlikoff, the dean of the Cornell University College of Veterinary
With that assertion, Kotlikoff revealed that Cornell is in the
exploratory phase of considering where to open its own satellite clinic.
Proposals include the New York City area and Connecticut.
The move by some veterinary medical programs to expand outward
seems to reflect the growth of veterinary medicine and specialty referral
hospitals, in particular. Twenty years ago, patients brought their pets to
teaching hospitals, and general veterinarians referred to them. Now the
majority of urban areas have their own specialists while most veterinary
schools are in rural areas.
These dynamics leave veterinary students without enough routine
care experience and schools “run the risk of becoming irrelevant,” Kotlikoff
While it is unclear whether a nationwide movement to build
satellite clinics is afoot in academia, a number of veterinary medical programs
have opened satellite facilities in recent years or have current plans for
them. Some argue that a veterinary medical program's expansion of services in areas
already populated by private practitioners, especially specialists, smacks of
unfair competition. After all, publicly funded satellite practices vie for the
same patients needed to fuel private practices, without the tax burdens
shouldered by small businesses.
Aware of the potential for such criticisms, Kotlikoff met with
private practitioners in New York's Westchester County to get a feel for local
attitudes concerning the veterinary college's proposed move to the area. But
without concrete plans, he said it is hard to talk seriously about the topic.
He characterized veterinary education's need to open satellite clinics —
specialty and primary care — as a way to be “much closer to the action."
Much like Cornell's plans, the University of Illinois opened a primary care and specialty practice in Chicago a few months ago. Kansas
State University runs a specialty practice in Omaha.
Oregon State University’s veterinary college did not open a
satellite clinic, but it created a partnership in 2007 to get students more
hands on training in spay and neuter by partnering with the Oregon Humane
Society. The program allows every student to do a rotation at the animal
shelter in Portland.
Perhaps the most recent example of a satellite expansion comes
from Mississippi State University (MSU), where officials expect to soon open a
specialty referral center in Jackson, more than two hours away from the
veterinary college's Starkville campus.
The greater Jackson area has a population of slightly more than
half a million people — roughly twenty times the population of Starkville. Yet
for all its size, Jackson has had no veterinary specialist in residence in the
area. That is why a group of about 35 local veterinarians asked the veterinary
college to establish a specialty referral practice there, said Dr. Kent Hoblet,
dean of MSU's College of Veterinary Medicine..
Those local veterinarians opened an all-night emergency clinic
and wanted someplace to send their serious cases. Now they're relocating the
emergency practice to a 5,200-square-foot building slated for completion this
fall, and MSU officials have reportedly purchased land adjacent to the site for
the specialty referral practice. A full-time surgeon has been hired and the
university’s specialty facility is expected to open in February.
Hoblet said the practice will, for the most part, run separately
from the school and its hospital, at least initially. Students and residents
will have the option to do an elective rotation there, and the practice may
become more integrated into the curriculum and research as time goes on.
“We think there are a lot of upsides to the clinic and our being
in Jackson,” Hoblet said. It will “increase opportunities for students. We’re
not a big school.”
Larger in size is the University of California, Davis School of
Veterinary Medicine (UC Davis), which opened a specialty clinic and
small-animal hemodialysis center in San Diego three years ago. It is the only
dialysis center in the region. But unlike in Jackson, the clinic is not the
only specialty practice in the area, and local practitioners objected to it.
Many still are unhappy, stating that it's unfair for a private
practice to have to compete with one that receives public funds. Some believe
that local resentment is a major and common consequence of the satellite
“UC Davis clearly stated that they were not going to come to the
area to compete with existing specialists,” said Dr. William Herndon, Dip
ACVIM, a cardiologist who practices near the UC Davis practice. But “clearly by
duplicating existing specialties and residencies at UC Davis-San Diego, UC
Davis was being dishonest about their intent to directly compete with private
The plan for the UC Davis facility in San Diego was initiated in
1998, when the state Legislature decided to address a shortage of veterinarians
in California and voted to fund the venture. At the time, there was a perceived
absence of veterinary specialists in the southern part of the state. Herndon estimated
that fewer than 15 specialists practiced in the area then.
Now there are at least 95, Herndon said.
Those specialists cannot compete against a practice that
operates tax free and is supported by tax dollars, he added.
The presence of the UC Davis clinic “has caused a decline in
case load” at Herndon's specialty group practice. “In fact, my hospital has had
to decrease the number of specialists employed,” he said.
For its part, UC Davis officials spoke with people in the area
as the school's plans developed and consciously decided to focus the practice
on behavior, nutrition and hemodialysis to minimize its competition with local
But conflict may be unavoidable. As more specialists work in
private rather than university-based practices and congregate in urban areas,
the schools get fewer of their traditional referrals, which translates to fewer
patients. That's prompted veterinary medical programs to expand to urban areas
in a quest to stay viable.
As Cornell’s Kotlikoff said, if veterinary medical schools do
not branch out and evolve, their teaching hospitals could become obsolete.