Illustration by Jon Williams
In an opinion piece published recently by the VIN News Service, Dr. Mark Helfat, a practice owner in New Jersey, argued for the preservation of independently owned companion animal clinics in the face of sweeping purchases by large corporations and investment groups backed by private equity.
Helfat reported that owners of small clinics who wish to retire are paradoxically having difficulty finding buyers, leaving those community-based clinics in danger of closing altogether. He implored younger veterinarians to consider practice ownership.
His commentary, Saving the soul of veterinary medicine, elicited a host of reactions on a message board of the Veterinary Information Network, an online community for the profession, as well as on social media and by email.
Here is a sampling of the responses.
I completely understand the concerns about the corporatization of veterinary care. The fears about loss of medical autonomy and individual concerns about retirement are totally valid and understandable.
What I don't understand is the assumption that the care provided by a DVM in a corporate-owned practice will lack compassion and commitment to clients and/or offer poorer-quality medicine. This seems like a huge leap and is a bit unfair to the docs currently working in a corporate-owned practice, whether in a uniform operation like Banfield or a practice that has been absorbed by a management group but still keeps its own name.
Compassion and client connection come down to the individual, not the building they're working in.
Alyssa Karklus, DVM
De Pere, Wisconsin
Being a practice owner changes how you think of yourself. Yes, it adds stress and might increase your work hours. It means the buck truly stops with you, and it's not for everyone. But much like graduating from vet school and being called "Doctor," it is a fundamental shift in your self-regard. ... I have traveled far more than any associate I know and made more money than I would have as an associate, and I have more confidence than had I never dealt with the things I had to face as a practice owner. For those on the fence, I believe that most will be happier in the long run if they take the plunge.
Lillian Roberts, DVM
Palm Desert, California
I truly loved the article because I went through it with my last employer. We "lost" the battle [for] privately owned, and it went corporate. The loss was devastating. Associates quit, veterinary technicians quit, receptionists quit, kennel staff quit, and other support staff quit. My question is, why don't smaller privately owned practices look to LVTs [licensed veterinary technicians] or other staff to buy in? I loved that clinic and worked extremely hard for 11 years there. I believed in that clinic. Why are we being overlooked?
Abbey Kozel, LVT
Simpsonville, South Carolina
As a former corporate employee, I take exception to the thought that corporates cannot have the same feel as a small, private practice. I worked for a seven-doctor corporate practice, and ... [o]ur receptionists knew clients and pets by name, we saw same-day emergencies and even urgent-cares — for our hospital and [for] neighboring hospitals that turned their own clients away (all privately owned). We had 30-minute appointments, and often ran over. I knew which of my clients had kids in college, a child on the way, an impending divorce, a serious health problem. ...
Most new grads have no interest in practice ownership. I have been there, too, and would not go back. I got paid more as an associate with a corporate than as a practice owner and had a fraction of the stress or risk. My 14 years with corporate were the best of my 30 years in practice. ...
I do understand the problem with small practices just having to close up shop, and that saddens me, as well. There will always be a place for those practices but they have to find a way to provide a living wage, benefits and work-life balance.
Teri Schweiss, DVM
Jersey Village, Texas
[O]ne of the key factors I try to relay to those shying away from ownership is that ownership is absolutely different from management. Unfortunately, I have seen many poorly managed practices. Almost all of them were owned and managed by veterinarians. The best practices are those run by managers, mine included. As other posters have pointed out, medical decisions and major business decisions (in consultation with those that know business) should be made by veterinarian owners. All other day-to-day matters can be handled by a good practice manager.
Steven Cudia, VMD
Toms River, New Jersey
[D]on't paint all younger vets as not wanting to buy in — they may have found or been told they seem to have little hope of buying (and hopefully not been burnt by an "old" vet stringing them along before selling to a corporate instead). And corporate [is] not evil — just needs something to change up top to stop the bleeding out of good staff.
Michelle Barton, BVSc
Arana Hills, Queensland, Australia
The smaller clinic practice model may have worked in the past, but the pressures of modern medicine, advanced workups being done by general practitioners, short staffing and inability to take adequate rest time have resulted in an enormous burnout problem. Let me reiterate: short staffing, leading to an enormous mental health problem.
Not to overgeneralize, but perhaps you had your prime career years subsidized by free child- and home-care. The world has changed. I apologize if this does not apply to you.
The future of the soul of veterinary medicine lies in practice management. It matters not who is ultimately paying the bills. Sustainable vet med now must include personal mental health care and the recognition that we do not live in the world of 80 [or even] 50 years ago.
Brittany White, DVM
[W]e noncorporate aging owners will need to be flexible regarding the sale of our practices and perhaps need to make a concerted effort to accept less or accept credit risk, instead of going for the biggest offer. I know I will not sell to a corporation because I will not be an employee at this stage of my career.
Maureen Dorsey, DVM
Being an associate veterinarian that has worked private and corporate practices, I will say that the most awful practices I have ever worked at (by a wide margin) have been privately owned practices. There is a lot of infrastructure that gets stuck on top of a corporate practice but they also seem to pay way more attention to HR [human resources] problems. I've been able to do a better job at corporate practices. I've had better work experiences at corporate practices. Yes, there is a profit incentive but it always felt more pronounced and present when I worked at a private practice. We, as a corporate practice, are seeing the patients of the private practices that aren't able to see their clients anymore. We try to get people in as fast as possible .... We take care of them as best we can. My bosses at my current (corporate) practice worry more about getting us all out on time than any other practice I've ever worked at.
... A lot of the nostalgia talk in this piece also smack[s] of "veterinary medicine is a life choice, not a job" kinda stuff that opens people up for all sorts of emotional abuse and usually starts resulting in guilty feelings for things like taking vacations and getting out on time. ("Are you really a caring person? You could have squeezed in a few more appointments so people wouldn't have to wait.")
Nicholas Hopkins, DVM
Albuquerque, New Mexico
As a practice owner myself, I agree [with] some of what Dr. Helfat has said, but I do feel that times are very different. I feel that this was a "Mayberry" point of view of clinic ownership. It's not that easy nor that simple. Business ownership tacks on significantly more responsibilities than just being a veterinarian. You are an accountant, an HR manager, a groundskeeper, the handywoman (you will need to be good with tools and painting), IT [information technology] person, and the list goes on.
Julia Servaites, DVM
I took a significant amount of money off the table in order to sell to my long-time associate rather than the corporation that I was working with. However, I was fortunate in that the real estate was able to provide enough for me to retire and sell the practice ... to my associate for a song. ... I'm holding the note for her, so getting financing wasn't an issue. Because I got the big chunk for the real estate, accepting the credit risk for her note is a little easier. ...
Practice ownership isn't for everyone, no doubt. But all those other jobs have always been a part of practice ownership. If managed correctly, a successful practice can hire a practice manager, a bookkeeper, an IT service, etc. ... [And] I took far more vacation time as an owner than I would have had as an associate because I managed my practice to allow me to do that. ...
My situation was unique, due the real estate component; it's a significant issue for a practice owner to decline a huge amount of money from a corporation to sell to an independent owner. Often, it would represent over half the value of the practice. That's a big ask of someone who is looking at retirement and cashing out of what probably represents his/her biggest asset. I'm not sure of the answer.
Brad Ochstein, DVM
West Palm Beach, Florida
I feel like I am contributing to the problem by being wholeheartedly a relief veterinarian, but I'm not willing to give that up. I hope I'm helping by giving clinic owners a break, but I have zero interest in ownership. I have the work/life balance I want. Financially, I am well set because I have a spouse who has had a pretty lucrative and stable military career, and we saved like crazy for our first 20 years so that we don't have to work more than we want for the next 20. I want to work into my 70s, and I know very few veterinarians who can say that! I love my work, but doing relief lets me mentally set boundaries that I think clinic owners usually can't, in my observation (and associates get a lot of pushback if they try). ...
I don't know what the solution is; I hope the relief market lasts for my career, but I have a daughter who thinks she wants to be a vet, and I wonder what the profession would be like for her.
Ariana Anderson, DVM
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.