Dear fellow veterinarians and devoted industry insiders, As I write this, Jan. 1 is dawning. It’s a beautiful day here in Miami and a great time to reflect on how prosperous a year veterinary medicine has enjoyed. Despite our many challenges, soon to be outlined below, our profession is flourishing. I, for one, am grateful to be a veterinarian in 2017. Please do not interpret anything below as evidence otherwise. For all its cracks and fissures, veterinary medicine is still the greatest profession on Earth. As such, I’m sure you’ll agree it merits some criticism. In the spirit of our collective betterment as this new year commences, I offer you this opinion-laced rundown of ways in which our industry is increasingly tested and taxed. 1. The Corporate Squeeze You can call me a Cassandra or liken me to Chicken Little, but it won’t change the reality: The power in our industry is becoming increasingly consolidated in the hands of nonveterinarians, which is not a good thing for those of us in the trenches. (I refuse to believe they have our clients’ and patients’ best interests at heart—not like we do, anyway.) This is shaping up to be the year in which 2016’s flurry of mergers and acquisitions comes to a conference near you and spreads the gospel of its wonders and its myriad promises: More products! More advertising! More patients! More! More! More! Does this pattern sound familiar? Yes, you can look to human health for examples on how this relentless dynamic has panned out poorly for professionals and consumers alike. Consider that less competition in any industry has never served anyone but the biggest stakeholders. I mean, everyone knows the middleman always gets the squeeze, right? The upshot: Regardless of how big and juicy you make that pie, it sucks when your slice is not only smaller but tastes like crap, too. 2. Reduced Private Independence A corollary to the big squeeze we’re feeling comes in the guise of more limited options than ever as far as making our own, independent way in the world. o There once was a time when solo practitioners could make an easy go of it. Not so in today’s economy. What with the economic advantages that bigness buys, banking’s tightfisted ways with startups, the challenging competitive landscape and fewer opportunities to buy—if you wanted to buy you’d probably be outbid by a corporate player—it’s a wonder we have any one-to-three-vet practices left at all. The end result of this limitation is a reduced freedom to maneuver and a concomitant rise in the potential for job dissatisfaction along with that loss of control. Indeed, it’s a wonder this factor isn’t mentioned more often when it comes to mental health issues in our profession. After all, the veterinary temperament is fundamentally independent. 3. The Money Gulf The yawning divide between rich and poor pet owners shows no signs of abating. Those with the finances and education will manage to redirect their disposable dollars toward their pets. Those with few to speak of will continue to show me their $40 and ask me how much that’ll buy. Heartbreaking. Moreover, as we build this castle ever higher, we’ll continue to face the harsh reality that this glorious standard of care we’re so proud of is leaving the majority of pet owners behind. And, as history shows, an uncomfortable uprising often accompanies economic disparities like this one. Could an antiveterinary backlash be too far behind? This is the biggest issue veterinary medicine faces as it enters 2017. What’s more, it’s not as if we can’t do something about it. Increased compassion toward price sensitivity at the micro level may not be profitable in the short term, but it’s worth millions in goodwill over the long haul. Note: Shoring up our shelter systems with need-based, low-cost, full-service care could be an essential element in that endeavor. Our VMAs need to work hard to help local governments dedicate municipal funds to these cost-effective measures. 4. A Culture Schism The nation’s culture wars, uncomfortably on display during 2016’s interminably acrimonious political season, have been dividing our profession for decades. Indeed, anyone inclined to look to the veterinary profession as a harbinger of impending acrimony in American culture (like me) might have predicted it. After all, our profession’s political environment has evolved as a unique place where the cultural divisions between rural and suburban practice have not just been magnified but codified, too. Consider a subset of this issue: 5. Our Inclusivity Challenges Since ours is arguably the whitest profession in America, and a conservative one at that, it only makes sense that we might have trouble attracting and maintaining veterinarians who hail from nonwhite backgrounds and less traditional cultures. As I see it, one of the biggest challenges this inclusivity question raises is the increasing disparity emerging between veterinarians and their staff and clientele. When veterinarians no longer look like most Americans, I see a big red flag for the profession’s long-term health. 6. A Regulatory Wild West Though it may not seem like it to you, veterinary medicine is considered highly unregulated relative to most other industries and a veritable Wild West compared to human health care. But that’s likely to change along with pet owners’ increasing willingness to take our profession to the mat. What’s more, the media is starting to take note. Consider the January article in Bloomberg News decrying both corporate medicine and our profession’s comparatively unregulated state of affairs. While journalistically flawed in all kinds of ways, the article got one thing right: Our unwillingness to side with our clients on issues like economic damages for pets is inconsistent with our espoused views on the human-animal bond, and it will bite us in the butt before too long. What’s more, our bullheadedness here and in other matters associated with how our clients afford veterinary care will likely lead to increased regulation in lots of other areas, not to mention significant loss in goodwill. I mean, if my annual PLIT insurance premium doubled I’d still only be making a payment on the order of an NAVC conference fee. 7. A Continuity Chasm We’re lucky enough not to labor under the onerous restrictions and byzantine machinations of the human health care system. So why have most of us come to accept the notion that general and emergency/specialty practice need be so divided? I’m not sure whether financial competitiveness or just plain poor management is more responsible, but, either way, we have no excuse not to improve our patients’ outcomes by managing their cases more effectively as a team. Though I had quite a few more on my list (mental health, student loans and animal welfare, among others) I think that’s enough from me this time. Stay tuned for more opinions as 2017 ramps up. Dr. Patty Khuly owns a small animal practice in Miami and is a passionate blogger at www.drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News. Originally published in the February 2017 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today!
