How to build or buy a vet practice even when you don't want to be a practice owner

The author's renovated lobby after she bought an existing practice. Courtesy of Patty Khuly. The lobby before renovation. Courtesy of Patty Khuly. In my last column, I promised to offer ideas on how to buy a veterinary practice when you’re the kind of person who never wanted to be a practice owner in the first place. In particular, I’m hoping this piece inspires those of you least interested in ownership with some off-the-beaten-path recommendations on how to make practice ownership work—even those of you who owe $200K-plus, and feel constitutionally ill-suited to ownership. First, let me recap the many reasons why you might just want to rethink your assumptions about practice ownership—especially those that steered you away from the possibility way back when you were a fetal veterinarian floating in your vet school’s womb: Because sometimes the best way out of debt is to take on more debt. I learned this the hard way and now, five years after buying a practice, I’m finally out of debt (as of last week, as a matter of fact). It wouldn’t have happened this quickly were it not for doing what I said I had no interest in ever doing (e. owning a practice). Okay, so I still owe on my mortgage, but my net worth is an actual positive number for the very first time in my life. (This is even better than having no debt!) Because it doesn’t have to be as hard as you think it is. (It’s way easier than vet school, that’s for sure!) Plenty of ownership opportunities require no more than an extra handful of hours a week—if that. Because if you don’t own a practice there’s more room for non-veterinarians to own one. This means someone other than a veterinarian is not only making decisions about how you do your job, they’re probably getting paid more than you are, too. Always remember: As a veterinarian, there’s no one better qualified to own a practice than you. Because there are so many more ways to own a practice than you may have thought possible, many of which require no greater business acumen than you currently possess. Because you’re worth more to yourself than anyone will ever pay you. Indeed, there’s no reason why anyone with the ambition and smarts to get through vet school should deny themselves the financial upside of practice ownership. I’m not saying you’ll be rich, but it’s very unlikely you’ll be less well-off in the long run. Get with colleagues and build a coalition Financially savvy new grads often share homes, apartments, and even cars. Why not band together to build or buy a practice? This arrangement isn’t as common as it once was, and yet it’s more necessary than ever. Everything’s way more affordable when two or more can pool resources—and that goes for the resources between your eyes, too. One of you is likely to have more business acumen while another is the bookish clinician wiz. Throw in a people person (and a good location) and you’ve got the recipe for a stellar practice. Expand your definition of veterinary professional partner When looking to build or buy as a team, consider that veterinarians aren’t the only veterinary professionals to choose from. Recognize that office managers and technicians have also dedicated their lives to this profession and, as such, are completely capable (in most states) of becoming practice owners (though sometimes only as minority owners). God knows more of them should be! To make my own practice purchase possible and address all the little details I’m not so good at managing, I partnered with a 20-year veteran veterinary office manager/bookkeeper. I could write a book about the many ways in which this uncommon 80/20 arrangement has made practice ownership doable—enjoyable, even. Yet, it’s the only partnership of its kind I’ve ever come across. Ask your boss(es) about buying in...slowly If you work for an independent practice and trust your boss(es), consider asking them whether they’d be willing to let you buy in...slowly (ergo, affordably). Lots of practice owners understand keeping associates happy is the key to a successful practice. But that’s hard to do when a) everyone thinks they’re better off as a free agent, and b) the grass starts looking greener elsewhere (but often really isn’t). Getting perfect-fit, Goldilocks-like associates to commit is the solution to everyone’s happiness. The answer some practice owners are starting to consider is a gradual buy-in. It starts with a current valuation everyone agrees upon, a percentage the associate will ultimately achieve, and a schedule for the payments that will be deducted from the associate’s compensation. It can be achieved as quickly (or as slowly) as both parties agree to. Additional issues include at what point the buyer can have a say in how the practice is run and issues surrounding how the practice can be sold. It’s not perfect but it’s what I’ll be doing to help ensure I have exit strategy options (so I don’t have to sell to a corporation), and it makes transitioning in and out of practice more fluid and less stressful for everyone. Done right, everyone is happy and associates stay put so patient care, client satisfaction, and veterinary sanity never suffer from needless turnover. Buy the ugliest house on the block This real estate truism holds in veterinary practice, too. The ugly duckling is usually the best use of limited resources, offering those with vision the best bang for their buck. After all, corporate players are buying up all the practices that fit a certain mold. Two docs or more, revenues above a certain threshold, etc. But who wants a one- or two-vet place in a crumbling strip mall? I did. It’s all I could afford. Five years later it’s unrecognizable, yet it still bears the same beating heart that served the community for 45 years before I bought it. If I hadn’t, I’m not sure it would still be there. And what a waste that would’ve been—for the community, the practice, its employees, and its former owners, who might’ve otherwise retired with more limited resources than they deserved for their life’s work. An original exam room, top, compared to a renovated dental-specific room, below. Photos courtesy of Patty Khuly. The allure of mobile practice Is fear of debt a huge psychological hurdle? Buying a mobile practice might sound appealing. All you need, when you get down to brass tacks, is your brain and a few extras. Which is great, sure, but it comes with risks, too. Whether you choose to invest in a truck or enter into a partnership with another veterinary facility, what you’re building with a mobile service is typically a one-vet enterprise. The goodwill you amass will be for yourself, not for the mobile service itself, which means you’ll have little to sell when you choose to move on. Despite the innate risks of mobile practice, this concierge-style service has its appeal—just you and your truck, freedom of the open road, and all that. The irony, however, is mobile small animal services are best designed as partnerships. After all, your services will be more reliable when there are two or more of you on hand to meet the vagaries of demand fluctuations. By design, this kind of mobile service is about more than just one guy/girl and his/her truck. And by extension, that means there’s more than just your personality and savvy to sell when it comes time to cash out. Tip: Look to equine models for inspiration but don’t get bogged down by the particulars. Small animals are another kettle of fish and creative thinkers can build their own practice to suit the unique contours of their communities. What a relief! Going it alone can be as easy as hanging up a virtual shingle and marketing yourself as a relief veterinarian. It’s the best way to get to know who’s who in the community and what kind of practice style fits you best. (It may be that permanent relief practice is your best fit.) By the way, joining your local VMA is similarly effective in achieving the networking goals necessary to build coalitions, establish partnerships and assess your immediate veterinary milieu. It’s service to your community, too, which is always nice. Want more options? There are so many more options than what I’ve included (including private/corporate partnerships and such) but I’ve tried to stick to the ones that allow veterinarians to own vet practices. Those of you interested in more options should look to the pharmacy industry where independent renegades have miraculously succeeded or human medicine and dentistry, where independent small practice ownership is still super-common and corporations haven’t made the impressive inroads into the industry we see in veterinary medicine. The key to modern practice ownership can be summarized as creativity and collaboration. If we don’t want to see more of the same attrition in independent practice ownership, more of us are going to have to get out there and make independent practices exist. So take it from someone who always said she’d never be a practice owner: Don’t remain forever wedded to your former self. Keep your mind open and perhaps you, too, will find yourself owning a practice...eventually. Patty Khuly, VMD, MBA, owns a small animal practice in Miami and is a passionate blogger at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of VPN Plus+.

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How to build or buy a vet practice even when you don't want to be a practice owner

Practice (ownership) makes perfect (sense)

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