Dr. Jeremy George
Photo courtesy of Dr. Jeremy George
As a new veterinary school graduate, Dr. Jeremy George found many prospective employers were turned off when he brought up his interest in owning or co-owning a practice within five years.
We didn't even have a ceremony. After four years of caffeine-induced, late-night hysteria, we received an email a week before our rescheduled graduation ceremony saying it was indefinitely postponed. No caps, no gowns, no witnesses to our receiving a piece of paper telling the world, "This person has earned the title of Doctor of Veterinary Medicine." Nevertheless, we moved on. We still became the newest generation of veterinarians and vowed to carry on the flame of our profession.
This was how the veterinary class of 2020 entered the profession. Many of us started our careers practicing curbside medicine, smiles hidden behind a mask and covering for coworkers who were out days at a time because they tested positive for Covid-19. Many of us drastically altered plans because the change in the global environment meant certain jobs were no longer available. We did what vet school taught us, we did what our mentors taught us and we did what every veterinarian has to do — we thought critically and adapted.
Recently, the VIN News Service published a commentary by Dr. Mark Helfat that caught my interest, Saving the soul of veterinary medicine. This thought-provoking commentary aroused lively discussion on a message board of the Veterinary Information Network, prompting responses for, against, and tangential to Dr. Helfat's views.
As I read through responses, it dawned on me that few veterinarians early in their careers seemed to be actively involved in the discussion. Concerned that the discussion might become an echo chamber, I voiced my thoughts.
This line from the commentary, which seemed to resonate with many readers, ignited my desire to speak up: "Without new blood, our soul will slip away, never to be seen again."
Do some think there is no new blood — there is no new generation that can and will guide veterinary medicine — or do they think it is the wrong blood?
As a less seasoned veterinarian, I felt this statement was an affront to me and my peers in the context of the entire article, which laments the diminishing number of locally owned veterinary practices, and claims those hospitals are the soul of veterinary medicine. Is this simply another generational complaint about shortcomings of "younger" generations of veterinarians? Perhaps I misunderstood, and this is a call to arms, not a snub. If that is the case, what are we fighting for? Whom are we fighting against?
Are we fighting against corporate entities and consolidation groups? If so, I have no intention to join the fight. Why should I?
A good salary, good benefits, work-life balance, ability to transfer to many different locations, access to novel diagnostics, access to specialists and access to a huge network of veterinarians at varying career stages are among their perks. Should I be aghast at anyone for choosing a position that offers financial stability rather than raging against the machine?
I do not necessarily like the corporatization and consolidation of veterinary medicine or of any industry, for that matter. But I understand it, and I understand why many of my peers may prefer these practices.
Have the seasoned veterinarians taken the time to survey younger veterinarians about their interpretations of the dilemma presented? I do not mean anecdotal discussions with one or two young veterinarians. I'm proposing a full survey. Perhaps VIN or the American Veterinary Medical Association can accomplish this task so that we can, at the very least, put numbers into focus.
How common was the desire to become a practice owner for most veterinarians in the past? How common is the desire to become a practice owner currently? If I am to believe what I read, our professional community thinks newer veterinarians don't want the hassle, and older veterinarians knew ownership was the best option for financial freedom, and frequently took the leap.
This narrative doesn't make sense to me. The Veterinary Business Management Association (VBMA) chapter at Auburn University College of Veterinary Medicine maintained approximately 60% enrollment from each class when I was in school there. This does not mean 60% of students want to own a practice, but clearly, these young veterinarians had, at least, a thirst to understand the business of veterinary medicine.
I was not a member of the VBMA. At that time, I had no interest in becoming a practice owner.
I grew interested in ownership when I was forced to reevaluate my post-graduation plans, which involved practicing marine animal medicine. I underwent a huge pivot from my goal; it seems a global pandemic can force you to alter decades' worth of preparation.
I contacted roughly 20 veterinary clinics for a position as an associate veterinarian. I had already gone through a short career and been forced to rethink a long-sought goal. I was running out of patience. I decided my new goal was practice ownership within five years of graduation.
Each clinic's response varied, and often, I was speaking with the practice manager rather than the owner or senior veterinarian. Nevertheless, of the hospitals I spoke to, only two responded positively to my question about potential ownership. The typical response fell more along the lines of, "Before we can have that discussion, we would need to know you are a good fit," or "It's too early in your career to know if you would want to be a practice owner." Those statements detracted from my desire to work there, and my questions about ownership seemed to detract from an employer's desire to continue with the interview process. I eventually signed on with one of the two hospitals that responded positively.
I pause here to ask you to ponder something (with the understanding that this is simply one person's experience):
If practice ownership was generally the goal of veterinarians in the past, why did the most common responses not encourage that goal? If the legacy of the veterinary clinic is so important, why did veterinarians back then begin selling to corporations and consolidation groups? Corporate consolidation is an outcome of decisions made by previous generations of veterinarians. New veterinarians today are tasked with adapting to the repercussions of those decisions.
My first practice was not my first choice. Another practice offered good mentorship and worked with the local marine animal stranding network. I was smitten. But when I asked about the opportunity for ownership, the answer was, "We are not currently looking to sell the practice."
I pressed: "I understand, but would you be open to discussing options to purchase into the clinic within five years?"
A tonal shift toward irritation seemed to occur. "That could be a possibility, but we would need to make sure you are a good fit here before we would be open to discussing that. I don't think we would be looking at a timeline of less than five years."
This conversation took place with the senior veterinarian. I did not ask if she was the owner, but I assumed as much. I admit that I was not, and am not, aware of the veterinarian's situation. It could be that she recently purchased the hospital and had yet to fully see returns on her investment. Perhaps she had a partnership in the past that soured. Maybe she just didn't want to relinquish any control. I didn't know, and it didn't matter. I had a course, and that practice wasn't on it.
I became an associate at a well-managed, productive, privately owned, multi-doctor hospital. There were myriad reasons for my selection but, importantly, I enjoyed the conversations with the senior veterinarian/owner, and he was responsive to the idea of ownership. We discussed how he purchased the clinic from his mentor, and he enjoyed the idea of a continued legacy.
This practice was recently purchased by a consolidation group. Before the sale was announced, there was no discussion with me or the other associates. A classmate (also employed at the practice) and I both, during our interviews and in later general conversations with the owner, had expressed interest in buying into or outright purchasing the practice. But having heard tales, time and again, of practices being sold from under associates and staff, we were not surprised.
I never asked why the decision was made to sell to a consolidator rather than approach the associates. There were no hard feelings. This seemed like a solid business decision. The owner likely was offered a sum that was much more than the associates would have been able to come up with. But ultimately, a decision was made without regard to a few younger veterinarians.
I recently became co-owner of a startup small animal practice. At 33 years old and only two years out of veterinary school, I assumed many would question my sanity. Not one person has — at least not to my face. I feel I have unbridled support and many helping hands in navigating the process. I feel like I have a seat at the table. It is fortunate I was able to, but unfortunate that I had to, build my own table.
All young veterinarians should feel heard. Although your associates may be unseasoned, they are the ones who ultimately will decide the fate of veterinary medicine. We were taught to think critically — let us! Are you actively being the mentor you promised to be, teaching new associates and letting their views be heard when you make decisions?
I hope to one day have associates at my practice. I hope I prepare them and listen to them in order to ensure that they are ready to achieve their goals, even if they don't align with mine. The partners and I have had many discussions about our visions for the future and our desire to empower our associates in ways we did not feel empowered. We have discussed starting a separate company to help young veterinarians navigate practice ownership. We have discussed offering new associates the option to buy into our practice so they never feel like they do not have a stake in the fate of the practice. We have discussed the eventuality of selling, and what that may entail.
Our discussions are difficult, and often there is no clear solution. But each discussion is an attempt to refocus on those we want to help. Veterinary medicine is magnificent because it continues to change the lives of our patients, our clients, our staff and our peers. Ultimately, if we continue to do that, I believe our soul will thrive.
Jeremy George graduated from Auburn University College of Veterinary Medicine in 2020. He owns a small animal practice in Inlet Beach, Florida. He had a short career in chemistry and at a startup toxicology and pharmacogenetics laboratory before attending veterinary school. As a student, Jeremy was active in the national Student American Veterinary Medical Association, particularly focusing on tuition transparency. Previously, Jeremy volunteered with Gulf World Marine Institute's marine animal stranding network and aided in conservation ecology projects.