big corporations in vet industry

[Ariel-Li]

I was glad to be selected student ambassador in my school for both Trupanion and Ethos, but it seriously upsets a clinician I used to work with. He's a practice owner (nice GP clinic with 3-4 doctors in a nice suburb, across the street from a Blue Pearl referral center). He says big corporations corrupt the industry and them seizing the pet insurance company made things even worse. I honestly haven't considered these issues and always feel I'd love to work in a big corporation after graduation - I love the huge caseloads and opportunities to work with different specialties, the salary is pretty competitive as far as I'm aware of. Anybody has a strong take on this issue?

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[battie]

I work for a hospital that sold to a huge corp 3 or 4 years ago. I have problems with my job, but I don't think they're in connection with the corporation itself, but rather GP in general. For the docs that were here prior to the sale, almost all of them dislike being owned by the corporate. Multiple docs have left at this point and there is concern that corp may step in soon due to some things going on.

 

[CalliopeDVM]

I think corporate ownership of vet clinics is bad for the profession - I think non-vet ownership of clinics is bad for business, and that includes big corporations (regardless of any legal paperwork, the places are run and decisions are made by non-vets).

 

[Ariel-Li]

I think corporate ownership of vet clinics is bad for the profession - I think non-vet ownership of clinics is bad for business, and that includes big corporations (regardless of any legal paperwork, the places are run and decisions are made by non-vets).

I agree with this on principle. However, do you have any examples where non-medical ownership hurts the interest of veterinarians and/or clients?

 

[DVMDream]

I agree with this on principle. However, do you have any examples where non-medical ownership hurts the interest of veterinarians and/or clients?

I think I have too many examples of this.

 

[CalliopeDVM]

do you have any examples where non-medical ownership hurts the interest of veterinarians and/or clients?

Many, because even though they say medical decisions are made only by the veterinarian(s), ultimately the budget decides what those veterinarians have to work with. That often means too few staff, poor quality staff, insufficient equipment, rushed appointments, etc.

 

[finnickthedog]

I had multiple experiences in private practices where they were understaffed, poor quality staff, underpaid, rushed appointments, insufficient equipment...

Meanwhile I work in a corporate owned--not a huge corp but growing--and none of those things other than not enough staff (which is true at pretty much every clinic I've set foot in lately) is true.

 

[DVMDream]

I mean you can have non-vet owned private practices too. I've been in them. In general, the owners don't understand medicine which can trickle down into other staffing and affect the way you can practice and affect your patients. I'll post a few examples when I get a moment. May be later today, may be next week sometime.

 

[finnickthedog]

To clarify, my experiences with privately owned practices that I was referring to were owned by vets.

 

[CalliopeDVM]

To clarify, my experiences with privately owned practices that I was referring to were owned by vets.

Sure, there will also be bad bosses and managers, but I believe it's a lot more frequent in large or small corporations because they enter into the business without any interest or care about medicine. They're hedge fund and private equity people.....It's just the latest fad in get-rich-quick ideas.

 

[MixedAnimals77]

This does not directly relate to your specific interests, but the corporate take over is also impacting mixed&LA practices adversely. Yes there are other issues at hand for mixed, LA and especially in particular rural practices. However, it's driving an even bigger divide than what already exists imo. There's no way these small private practice will ever be able to attract people with 75k+ sign-on bonuses. In my home state the small rural guys are doing ok to be competitive on a base level but these signing bonuses are killing them. Plus corporations are making decisions purely based on the $ and usually don't consider the impact on the community and usually do work against mixed/LA practices. One example I know of is a corporate bought a mixed practice. Said practice did some LA work initially. Calf chains broke. Corporate now says new calf chains aren't in the budget effectively killing any dystocia work. Similar things happening as they run out of LA meds. Now LA clients have to drive 2+hrs to get help. Is it corporates place to consider the community effects-no, but should they-maybe.

I have one classmate who is 100% a cattle guy who I would have never pegged as doing small animal seriously considering going 100% small animal med because of the financial aspect like this and then maybe trying to start his own LA stuff on the side.

I realize this is a small sliver of the issues that plague mixed&LA especially those located rurally, but I think it does contribute to the problem.

 

[MrFahrenheit]

It seems like the "mom and pop" hospitals are the way to go..if you can get in.

 

[DVMDream]

So the issue with vet clinics not run or owned by veterinarians is that they just do not understand medicine. They do not get it. They have no concept about medicine, what it entails and even worse they don't know just what they don't know and quite frankly, I have yet to be convinced that they actually care.

For example, I had a corporate clinic inform me that I could not refer a GDV to ER and we had to do it in-house. Neither myself nor the other vet working that day have performed a GDV surgery before. Their techs are not familiar with a GDV procedure. Not to mention, this particular patient had been symptomatic for some time, so there is concern for is the stomach dead or no? Is the spleen involved or no? Are we prepared to resect part of the stomach? The entire spleen (this part probably wasn't a big deal). Will the dog need blood or no? Also this dog was having obvious arrhythmias simply on auscultation, which is not an uncommon complication with GDV but often gets worse with surgery and in post-op, we don't really have telemetry. I explain this all to them and they just don't get it. They don't see the "big deal" we can just do the surgery and then refer for ER to monitor. I had to very firmly put my foot down and refuse. I told them in no uncertain terms I would be offering this owner referral to a facility better equipped to handle this pet's emergency as that is what I would want for my pet and if they don't like that, they are welcome to obtain their own DVM license and do it whatever way they wish.

I have been told that a laceration repair is not a surgery.

Even catching the "little" mistakes incorrect meds, doses, etc being sent out, they don't comprehend how serious those things can be. They are just "meh, we caught it". Ok, that isn't enough we need to prevent it because what happens when we don't catch the next one?

I have seen corporate clinics hang onto toxic employees for way too long because they have "been there forever." (This can happen in non-corporate clinics also but it seems a bit less likely). I have also seen them hang on to employees that clearly were not working out in their initial probationary period and they still refuse to let them go. I actually left a clinic in part because of this. This particular person made my job difficult and I was constantly concerned about her causing a fatal error and she almost did on multiple occasions. I had to leave to protect my license.

Have had them not understand why we can't "babysit" a brachycephalic dog whose owner admits the dog is having breathing issues at night and he just wants us to watch it, but not examine, diagnose, treat, etc. Just watch the dog. Um, no, we aren't a boarding facility and we didn't have an oxygen kennel at this clinic, so really not setting us up for success here if the dog does have an issue. I can see it, but I am not babysitting it for the day. Talk about setting us up for a giant liability if things go south and brachycephalic + breathing issues = badness fast.

I watched one keep on a DVM that wasn't just practicing bad medicine, practically every patient he touched was a malpractice case. It was very difficult to watch and despite numerous vets voicing loud complaints, they didn't care. What finally convinced them to fire this DVM-- not malpractice, not unproven holistic medicine that he'd spend hours doing while ignoring his other appointments as the other vets picked up the slack. Nope. Not any of that. What finally made them fire him-- he didn't follow their exact protocol/flow for euthanasia.

They have no concept on how medicine works, what it entails and how long certain things can take. They schedule things out in ways that don't always make sense. From 15 minute appointments to "why can't you just do this abdominocentesis on this dog that took 3 hours last time in between seeing other exam rooms".... umm, because that isn't how this works. To what do you mean you can't do 6 trench mouth dentals in 3 hours before lunch and then be ready to jump into exam rooms when you are done? Comments of "it is just a new puppy appointment only takes 5 minutes" (should take a good 20-30 minutes if doing it properly) to "it is just a vaccine" (nothing is EVER just a vaccine), they don't comprehend that good, quality medicine takes time. Building client rapport takes time.

Corporate is all about stats-- how many patients did you see in a day. What is you average client transaction? How much money did you bring in? Well if you see more you will bring in more money (which is not true, actually there is a point where the more you see, the less you bring in because you can't build client relationships if you only get 5-10 minutes in an exam room and owners start declining treatments and diagnostics because quite frankly, the communication just wasn't there). Any place that has 15 minute appointments is giving you maybe 5-7 minutes (10 max) with the client the other part of that 15 minute appointment is your tech/assistant placing the client in the exam room, obtaining a history and vitals and if you have a slow tech/assistant, they might take up all 15 minutes. Don't forget to add in the client was 5 minutes late to the appointment.

Anyway, I could go on forever.

In general though, there are things that a DVM employer will understand and listen to your concerns about that you will never get a non-DVM employer to care about. There can be some overlap, of course, there can be not great DVM employers, but overall a vet will understand medicine and where their associates are coming from better than corporate. Corporates end goal is money, more money, no wait, more money. Keep going, the CEO needs a 5th helicopter.

 

[CalliopeDVM]

they don't know just what they don't know and quite frankly, I have yet to be convinced that they actually care.

THIS!

 

[Ariel-Li]

So the issue with vet clinics not run or owned by veterinarians is that they just do not understand medicine. They do not get it. They have no concept about medicine, what it entails and even worse they don't know just what they don't know and quite frankly, I have yet to be convinced that they actually care.

For example, I had a corporate clinic inform me that I could not refer a GDV to ER and we had to do it in-house. Neither myself nor the other vet working that day have performed a GDV surgery before. Their techs are not familiar with a GDV procedure. Not to mention, this particular patient had been symptomatic for some time, so there is concern for is the stomach dead or no? Is the spleen involved or no? Are we prepared to resect part of the stomach? The entire spleen (this part probably wasn't a big deal). Will the dog need blood or no? Also this dog was having obvious arrhythmias simply on auscultation, which is not an uncommon complication with GDV but often gets worse with surgery and in post-op, we don't really have telemetry. I explain this all to them and they just don't get it. They don't see the "big deal" we can just do the surgery and then refer for ER to monitor. I had to very firmly put my foot down and refuse. I told them in no uncertain terms I would be offering this owner referral to a facility better equipped to handle this pet's emergency as that is what I would want for my pet and if they don't like that, they are welcome to obtain their own DVM license and do it whatever way they wish.

I have been told that a laceration repair is not a surgery.

Even catching the "little" mistakes incorrect meds, doses, etc being sent out, they don't comprehend how serious those things can be. They are just "meh, we caught it". Ok, that isn't enough we need to prevent it because what happens when we don't catch the next one?

I have seen corporate clinics hang onto toxic employees for way too long because they have "been there forever." (This can happen in non-corporate clinics also but it seems a bit less likely). I have also seen them hang on to employees that clearly were not working out in their initial probationary period and they still refuse to let them go. I actually left a clinic in part because of this. This particular person made my job difficult and I was constantly concerned about her causing a fatal error and she almost did on multiple occasions. I had to leave to protect my license.

Have had them not understand why we can't "babysit" a brachycephalic dog whose owner admits the dog is having breathing issues at night and he just wants us to watch it, but not examine, diagnose, treat, etc. Just watch the dog. Um, no, we aren't a boarding facility and we didn't have an oxygen kennel at this clinic, so really not setting us up for success here if the dog does have an issue. I can see it, but I am not babysitting it for the day. Talk about setting us up for a giant liability if things go south and brachycephalic + breathing issues = badness fast.

I watched one keep on a DVM that wasn't just practicing bad medicine, practically every patient he touched was a malpractice case. It was very difficult to watch and despite numerous vets voicing loud complaints, they didn't care. What finally convinced them to fire this DVM-- not malpractice, not unproven holistic medicine that he'd spend hours doing while ignoring his other appointments as the other vets picked up the slack. Nope. Not any of that. What finally made them fire him-- he didn't follow their exact protocol/flow for euthanasia.

They have no concept on how medicine works, what it entails and how long certain things can take. They schedule things out in ways that don't always make sense. From 15 minute appointments to "why can't you just do this abdominocentesis on this dog that took 3 hours last time in between seeing other exam rooms".... umm, because that isn't how this works. To what do you mean you can't do 6 trench mouth dentals in 3 hours before lunch and then be ready to jump into exam rooms when you are done? Comments of "it is just a new puppy appointment only takes 5 minutes" (should take a good 20-30 minutes if doing it properly) to "it is just a vaccine" (nothing is EVER just a vaccine), they don't comprehend that good, quality medicine takes time. Building client rapport takes time.

Corporate is all about stats-- how many patients did you see in a day. What is you average client transaction? How much money did you bring in? Well if you see more you will bring in more money (which is not true, actually there is a point where the more you see, the less you bring in because you can't build client relationships if you only get 5-10 minutes in an exam room and owners start declining treatments and diagnostics because quite frankly, the communication just wasn't there). Any place that has 15 minute appointments is giving you maybe 5-7 minutes (10 max) with the client the other part of that 15 minute appointment is your tech/assistant placing the client in the exam room, obtaining a history and vitals and if you have a slow tech/assistant, they might take up all 15 minutes. Don't forget to add in the client was 5 minutes late to the appointment.

Anyway, I could go on forever.

In general though, there are things that a DVM employer will understand and listen to your concerns about that you will never get a non-DVM employer to care about. There can be some overlap, of course, there can be not great DVM employers, but overall a vet will understand medicine and where their associates are coming from better than corporate. Corporates end goal is money, more money, no wait, more money. Keep going, the CEO needs a 5th helicopter.

That indeed is very concerning and I'd be driven up the wall with employer like this.

I'm wondering if this applies more to general practice side of work? I worked (and I'm working) in 24/7 referral hospital that belongs to a national chain, and sure we have our problems but I'm afraid those are problems every practice faces, private or corporate-owned: abusive clients, short-staff (even with constant hiring ads and lucrative bonus), etc. Our directors are DVMs (specialists actually), and our managers are CVTs with 20ish years of work experience. I felt pretty good working there as a tech and will consider working there after graduation - this is after talking with many ER doctors and specialists working there.

I guess my question is, is it such an evil thing if vetmed is ran like a business? 100% business model would be terrible, I get that. But realistically, can we envision a successful and sustainable veterinary hospital NOT also a successful business entity? What you described, it's not only bad medicine, it's also just bad business. Stupid owner. Ineffective feedback mechanism. Unwillingness to consult expert. Are corporations inherently vulnerable to these managerial faults?

 

[DVMDream]

That indeed is very concerning and I'd be driven up the wall with employer like this.

I'm wondering if this applies more to general practice side of work? I worked (and I'm working) in 24/7 referral hospital that belongs to a national chain, and sure we have our problems but I'm afraid those are problems every practice faces, private or corporate-owned: abusive clients, short-staff (even with constant hiring ads and lucrative bonus), etc. Our directors are DVMs (specialists actually), and our managers are CVTs with 20ish years of work experience. I felt pretty good working there as a tech and will consider working there after graduation - this is after talking with many ER doctors and specialists working there.

I guess my question is, is it such an evil thing if vetmed is ran like a business? 100% business model would be terrible, I get that. But realistically, can we envision a successful and sustainable veterinary hospital NOT also a successful business entity? What you described, it's not only bad medicine, it's also just bad business. Stupid owner. Ineffective feedback mechanism. Unwillingness to consult expert. Are corporations inherently vulnerable to these managerial faults?

I also worked in a 24/7 referral hospital a bit as relief and similar issues can be found in those as well.

I didn't mention anything about abusive clients, short-staff, etc because those are industry-wide issues, so not sure why you are bringing them up? I know others mentioned them above, but these are industry-wide issues that will occur regardless of the clinic type. Though you are much more likely to get an abusive client fired in a DVM owned clinic and in the corporate owned clinic the abusive client will have their ass kiss, whatever they want handed to them on a silver platter while you are scolded for whatever they client perceived you did "wrong" even though you didn't do anything wrong.


You asked if corporate is bad for vet med, not if vet med should be run like a business. Yes, all veterinary clinics are run like a business or they will fail and cease to exist. But we aren't talking about running things like a business, we are talking about how corporate runs a business in particular and how that affects veterinary medicine for both the people that work there and the clientele/patient care. Most corporations have a similar mind-think, if you work in enough of them you see the same things trickle down from the powers that be up high to the regional directors, then to the particular clinic director, then to the managers and then eventually to the staff. It happens in specialty medicine corporate owned as well. Decisions are made by someone sitting in a comfy chair in an office who has never stepped foot in a veterinary clinic and the decisions are not run by the DVMs first and those decisions eventually trickle into the clinic, for better or worse, most commonly for worse.


Look, some people are happy working for corporate and can ignore/brush off the corporate mind-think and random bull**** decisions that come through, because the rest of what they are receiving makes the frustrations worth it to them. Others absolutely despise corporate because we see how they are ruining the field. Slowly but surely, we are pricing ourselves out of service because of the corporates. They are slowly pushing towards an insurance model, look at the partnerships with trupanion (I puke a little every time I see an ad about it). They are starting to also push towards attempts to get mid-levels (think veterinary nurse practitioners). Basically anything corporate can do that will ultimately line their pockets with money, regardless of how badly it further shoves the field into the ground and destroys veterinarians, they don't care, they will do it. Whereas your DVM owner will recognize how bad it is to go down that path of pricing ourselves out of service, selling our souls to insurance or agreeing to mid-levels in the field.

But hey, you do you. If you are happy with all that and realizing that you, yourself, won't be able to afford care for your own pet with your salary as a DVM, unless you have insurance or significant savings, then go for it. If you are excited for the day when Trupanion gets to tell you how and when and what you will use to treat a pet akin to how human medicine insurance currently does, go for it. (Yes, we are underpaid, yes, we deserve more, but we aren't getting paid much more and our services are ever increasing in price, where do you think that extra $$$ is going?).


If you enjoy figuring out what your "canine color" is or taking your Meyer-Briggs test every single year so corporate can have some "knowledge about who you are" instead of just talking to you. Go for it. Or even worse, taking these tests and then having your employer use them in order to "manage you" based on your canine color and basically run the staff off these blocks of "personality" (seriously they did this, I rolled my eyes daily when they'd bring up "well so and so is a blue so they should blah blah blah). If you like cheesy ass meetings about "getting to know" people, you go right for it. Personally I get sick of the cheesy ass meetings pretending like they cared (basically pulls the wool over the eyes of the techs/assistants/volunteers/anyone that isn't a DVM) while simultaneously being told I suck and don't do enough despite already being worked to the bone.

Some people like their corporate jobs, they can ignore the random fluff and bull****, and some people are just stuck putting up with it because corporate has taken over the field and we don't have many other options. Some people buy the corporate mind-think hook, line and sinker, and jump right in with the same mentality, I just refuse to sell my soul. I am now at a place of basically beaten into submission, there is nowhere else to go, so I put my head down, do my job, ignore what isn't worth fighting over and go home at the end of the day. Every day is very much a "pick your battles" today and every day I have to just suppress all the feels, do the best I can to help the pets and go home to enjoy the things I now like better than veterinary medicine.

Ultimately, you have to just figure out what you are happy with, after all, it is your career and your life so you have to do what makes you happy. If that is working in a corporate 24/7 specialty clinic, go for it. If that is working for Banfield, go for it. If that is working for a private practice DVM owned clinic, go for it. If that is deciding you want to visit space with a cat in tow, go for it. The decision is yours and I 100% support you doing what ultimately makes and keeps you happy. And what makes you happy now, might not in 2 years. Or what makes you happy in the next 5 years, may not continue to make you happy in 10 years, ultimately, find what makes you happy, what keeps you sane in this crazy field and run with that.

 

[Ariel-Li]

I also worked in a 24/7 referral hospital a bit as relief and similar issues can be found in those as well.

I didn't mention anything about abusive clients, short-staff, etc because those are industry-wide issues, so not sure why you are bringing them up? I know others mentioned them above, but these are industry-wide issues that will occur regardless of the clinic type. Though you are much more likely to get an abusive client fired in a DVM owned clinic and in the corporate owned clinic the abusive client will have their ass kiss, whatever they want handed to them on a silver platter while you are scolded for whatever they client perceived you did "wrong" even though you didn't do anything wrong.


You asked if corporate is bad for vet med, not if vet med should be run like a business. Yes, all veterinary clinics are run like a business or they will fail and cease to exist. But we aren't talking about running things like a business, we are talking about how corporate runs a business in particular and how that affects veterinary medicine for both the people that work there and the clientele/patient care. Most corporations have a similar mind-think, if you work in enough of them you see the same things trickle down from the powers that be up high to the regional directors, then to the particular clinic director, then to the managers and then eventually to the staff. It happens in specialty medicine corporate owned as well. Decisions are made by someone sitting in a comfy chair in an office who has never stepped foot in a veterinary clinic and the decisions are not run by the DVMs first and those decisions eventually trickle into the clinic, for better or worse, most commonly for worse.


Look, some people are happy working for corporate and can ignore/brush off the corporate mind-think and random bull**** decisions that come through, because the rest of what they are receiving makes the frustrations worth it to them. Others absolutely despise corporate because we see how they are ruining the field. Slowly but surely, we are pricing ourselves out of service because of the corporates. They are slowly pushing towards an insurance model, look at the partnerships with trupanion (I puke a little every time I see an ad about it). They are starting to also push towards attempts to get mid-levels (think veterinary nurse practitioners). Basically anything corporate can do that will ultimately line their pockets with money, regardless of how badly it further shoves the field into the ground and destroys veterinarians, they don't care, they will do it. Whereas your DVM owner will recognize how bad it is to go down that path of pricing ourselves out of service, selling our souls to insurance or agreeing to mid-levels in the field.

But hey, you do you. If you are happy with all that and realizing that you, yourself, won't be able to afford care for your own pet with your salary as a DVM, unless you have insurance or significant savings, then go for it. If you are excited for the day when Trupanion gets to tell you how and when and what you will use to treat a pet akin to how human medicine insurance currently does, go for it. (Yes, we are underpaid, yes, we deserve more, but we aren't getting paid much more and our services are ever increasing in price, where do you think that extra $$$ is going?).


If you enjoy figuring out what your "canine color" is or taking your Meyer-Briggs test every single year so corporate can have some "knowledge about who you are" instead of just talking to you. Go for it. Or even worse, taking these tests and then having your employer use them in order to "manage you" based on your canine color and basically run the staff off these blocks of "personality" (seriously they did this, I rolled my eyes daily when they'd bring up "well so and so is a blue so they should blah blah blah). If you like cheesy ass meetings about "getting to know" people, you go right for it. Personally I get sick of the cheesy ass meetings pretending like they cared (basically pulls the wool over the eyes of the techs/assistants/volunteers/anyone that isn't a DVM) while simultaneously being told I suck and don't do enough despite already being worked to the bone.

Some people like their corporate jobs, they can ignore the random fluff and bull****, and some people are just stuck putting up with it because corporate has taken over the field and we don't have many other options. Some people buy the corporate mind-think hook, line and sinker, and jump right in with the same mentality, I just refuse to sell my soul. I am now at a place of basically beaten into submission, there is nowhere else to go, so I put my head down, do my job, ignore what isn't worth fighting over and go home at the end of the day. Every day is very much a "pick your battles" today and every day I have to just suppress all the feels, do the best I can to help the pets and go home to enjoy the things I now like better than veterinary medicine.

Ultimately, you have to just figure out what you are happy with, after all, it is your career and your life so you have to do what makes you happy. If that is working in a corporate 24/7 specialty clinic, go for it. If that is working for Banfield, go for it. If that is working for a private practice DVM owned clinic, go for it. If that is deciding you want to visit space with a cat in tow, go for it. The decision is yours and I 100% support you doing what ultimately makes and keeps you happy. And what makes you happy now, might not in 2 years. Or what makes you happy in the next 5 years, may not continue to make you happy in 10 years, ultimately, find what makes you happy, what keeps you sane in this crazy field and run with that.

I get the feeling that my post upsetted you, and I'm really sorry about that. Look, I posted the question because I wanted to understand. I don't have a firm position on this matter (a predisposition maybe, but I was not convinced either way) because I'm so new to the field. I came from a different major and a different country, and all my vet experience was from the past 4 years or so, in one city in the US. So I lack perspective. And I really want to understand.

By the way, sometimes I feel that the whole English-as-second-language thing limited my capacity in communication. I may come off presumptive, rude, or offensive without realizing it. I apologize again if my previous post sounded that way.

Now, you mentioned something I never heard of before. Does Trupanion dictate how veterinarians practice medicine? That indeed would be terrifying. If they did, would you care to elaborate more on how? Do you also see such problems with other insurance companies? Would you say pet insurance industry is hurting vetmed - I always thought the opposite, and if I'm wrong, I definitely want to know it!

And the rising cost of veterinary care. I do see that, everyday. I didn't realize that corporate ownership was the cause of it. I thought it was inflation or something to that effect, and hey, medicine is so incredibly expensive here in the states (victim of some bad student insurance here LOL). I am an active proponent of accessible veterinary care and gradients of care in my school, if it matters. Do you see a way out of this situation? Or, maybe this is the same question put in a different way - I don't assume we could ever go back to the mom-and-pop hospitals at this point, so going forward is there anything we as individual veterinarians can do to improve the situation?

And thank you again for your very thoughtful responses!

 

[battie]

And the rising cost of veterinary care. I do see that, everyday. I didn't realize that corporate ownership was the cause of it.

Just one experience, but my hospital now charges more for an ultrasound (performed by GPs/ER docs that did a ton of CE) than the local boarded internists do by a significant margin. It's causing significant strife amongst the doctor crew because we simply don't have the same level of knowledge or skill. I'm not sure how much control we have to be able to uniformly deny increases in prices.

 

[SkiOtter]

Though you are much more likely to get an abusive client fired in a DVM owned clinic and in the corporate owned clinic the abusive client will have their ass kiss, whatever they want handed to them on a silver platter while you are scolded for whatever they client perceived you did "wrong" even though you didn't do anything wrong.

I’ve actually had the opposite experience where I’ve seen DVM owned clinics more willing to kiss ass than the corporates I’ve seen. Some DVM owned rely more heavily on their online reviews and will do whatever to keep the client happy where corporate will actually fire someone because they are not struggling and don’t need their business. Obviously not like that everywhere, but your post was essentially saying the opposite of my experience so I figured I’d share it for others 🤷🏻‍♀️

 

[SkiOtter]

Now, you mentioned something I never heard of before. Does Trupanion dictate how veterinarians practice medicine?

I believe she’s referring more to how human medicine insurance works where your insurance will only cover certain meds unless those meds have all been tried and failed and DVMD is assuming that vetmed would go that way too. Trupanion is just one of the only companies currently who will pay the vet directly (if the hospital is signed up to receive payment like that) like how human medicine works vs the client having to submit a claim for reimbursement after already paying out of pocket at the vet.

 

[DVMDream]

I get the feeling that my post upsetted you, and I'm really sorry about that. Look, I posted the question because I wanted to understand. I don't have a firm position on this matter (a predisposition maybe, but I was not convinced either way) because I'm so new to the field. I came from a different major and a different country, and all my vet experience was from the past 4 years or so, in one city in the US. So I lack perspective. And I really want to understand.

By the way, sometimes I feel that the whole English-as-second-language thing limited my capacity in communication. I may come off presumptive, rude, or offensive without realizing it. I apologize again if my previous post sounded that way.

Now, you mentioned something I never heard of before. Does Trupanion dictate how veterinarians practice medicine? That indeed would be terrifying. If they did, would you care to elaborate more on how? Do you also see such problems with other insurance companies? Would you say pet insurance industry is hurting vetmed - I always thought the opposite, and if I'm wrong, I definitely want to know it!

And the rising cost of veterinary care. I do see that, everyday. I didn't realize that corporate ownership was the cause of it. I thought it was inflation or something to that effect, and hey, medicine is so incredibly expensive here in the states (victim of some bad student insurance here LOL). I am an active proponent of accessible veterinary care and gradients of care in my school, if it matters. Do you see a way out of this situation? Or, maybe this is the same question put in a different way - I don't assume we could ever go back to the mom-and-pop hospitals at this point, so going forward is there anything we as individual veterinarians can do to improve the situation?

And thank you again for your very thoughtful responses!

Sorry if it seemed like I was upset. Not upset at all. I know many colleagues that rave about their corporate job. Experiences will be variable. And then there's a lot of other colleagues that see how the introduction of corporate has slowly caused vet med to trend a certain direction and we're not convinced based on our experiences it is a good trend. And the latter is probably where the clinician you know is sitting, so he's probably a wee bit disappointed that corporate has swooped up yet one more person.

 

[DVMDream]

I believe she’s referring more to how human medicine insurance works where your insurance will only cover certain meds unless those meds have all been tried and failed and DVMD is assuming that vetmed would go that way too. Trupanion is just one of the only companies currently who will pay the vet directly (if the hospital is signed up to receive payment like that) like how human medicine works vs the client having to submit a claim for reimbursement after already paying out of pocket at the vet.

This, I can totally see if we aren't cautious with how we accept pet health insurance it will become like human medical insurance, where you have to get permission for everything before you can do it and they can tell you that you must try x med before you can try y med. I mean you already have to get approval from trupanion at the clinics they are linked with for direct pay before you can proceed.

But when you have giant corporate (trupanion) and giant corporate (VCA) working together, you really think they're going to listen to us vets saying no don't do that? They're going to do what works best for them $$$$ and not what works best for patient care.

 

[Minnerbelle]

I dunno man. I’ve worked for two corporate practices, and two privately owned practices as an associate. They sure aren’t perfect, and have their set of issues, but I didn’t see the corporate entity as evil as everyone else seems to. I don’t necessarily disagree about people’s gripes with corporate, but Private clinics aren’t all peachy either. And also, let’s not talk about “corporate” as if they’re all the same either. VCA =/= Banfield =/= Blue Pearl =/= all the secret corporate disguised as independent hospitals, etc…

Private clinic owners often have very little HR/management training. It is common that they blatantly break employment laws. Unfortunately, your only recourse as an employee in this totalitarian state is to live with it, quit, sue, or put in a complaint with the labor board. At least at the corporate level (though you can always have stupid managers that stray from it), HR will typically be careful not to break employment laws. On the flip side to corps being “about profit,” private clinic owners can make poor business/management decisions based on their emotions/personal experience/anecdotes… and that can also get ugly. On the medical standards front, corps often at least have some sort of medical oversight/standard of care (though it’s not perfect and of course there are some problematic examples and of course some ****ty doctors are employed in the corporate world and not addressed).

I dunno, maybe this is just my experience, but I was treated much better as a doctor by corporate than either private clinics. I was also encouraged to practice much better medicine in the corporate world (better medicine = more money). And looking back, both of these things actually mattered a lot. While in the thick of it, of course I was annoyed by this and that corporate shenanigans… but if I were to go back to becoming a full time associate, I’m more likely to go back to corporate. I’ve just been burned too many times by ****ty bosses who told me about how amazing they were and how I would be treated like family or whatever. At least with corporate, I know better what to expect.

And yes, corp prob has driven up costs of care. That actually really hurts my soul as someone who cares about accessibility of care. But at the same time, if you don’t charge more for your services, you either have to do more volume to earn the same amount, or work the same amount and make less money. And ****ty pay is something vets complain about all the time, so I don’t think we can really ignore that.

 

[DVMDream]

I dunno man. I’ve worked for two corporate practices, and two privately owned practices as an associate. They sure aren’t perfect, and have their set of issues, but I didn’t see the corporate entity as evil as everyone else seems to. I don’t necessarily disagree about people’s gripes with corporate, but Private clinics aren’t all peachy either. And also, let’s not talk about “corporate” as if they’re all the same either. VCA =/= Banfield =/= Blue Pearl =/= all the secret corporate disguised as independent hospitals, etc…

Private clinic owners often have very little HR/management training. It is common that they blatantly break employment laws. Unfortunately, your only recourse as an employee in this totalitarian state is to live with it, quit, sue, or put in a complaint with the labor board. At least at the corporate level (though you can always have stupid managers that stray from it), HR will typically be careful not to break employment laws. On the flip side to corps being “about profit,” private clinic owners can make poor business/management decisions based on their emotions/personal experience/anecdotes… and that can also get ugly. On the medical standards front, corps often at least have some sort of medical oversight/standard of care (though it’s not perfect and of course there are some problematic examples and of course some ****ty doctors are employed in the corporate world and not addressed).

I dunno, maybe this is just my experience, but I was treated much better as a doctor by corporate than either private clinics. I was also encouraged to practice much better medicine in the corporate world (better medicine = more money). And looking back, both of these things actually mattered a lot. While in the thick of it, of course I was annoyed by this and that corporate shenanigans… but if I were to go back to becoming a full time associate, I’m more likely to go back to corporate. I’ve just been burned too many times by ****ty bosses who told me about how amazing they were and how I would be treated like family or whatever. At least with corporate, I know better what to expect.

And yes, corp prob has driven up costs of care. That actually really hurts my soul as someone who cares about accessibility of care. But at the same time, if you don’t charge more for your services, you either have to do more volume to earn the same amount, or work the same amount and make less money. And ****ty pay is something vets complain about all the time, so I don’t think we can really ignore that.

I've definitely worked in some ****ty private practices, the one I'm really thinking of wasn't owned by a vet. Basically ****ty practices can happen anywhere. And every job will have negatives and frustrations, so I just encourage finding what works for you. Honestly I was treated fairly well with Banfield but I was the relief vet, so that very well could change as an employee. Plus as relief I went to multiple Banfield clinics and they're all different, just depends on the management there. VCA was a hot mess in my opinion. So it all really just depends and not everyone's experience is the same, a lot depends on regional management.

 

[that redhead]

This is a tough one. I’ve never worked for corporate GP, only privately owned (by a vet.) There were plenty of issues with those similar to what DVMD lists as issues for corporately owned I think you’ll find bad apples either way.

As for corrupting the industry? I can see how private clinic owners would feel that way. All clinics are having a tough time attracting help at every level; corporate has the “resources” to out-compete the little guy: Signing bonuses, benefits, etc that many small businesses can’t afford or don’t want to prioritize. I read a post on VIN the other day complaining about how associates are asking so much more for compensation and was that reasonable? Corporations have far deeper pockets and financial stability/predictability and can meet those demands whereas small businesses simply don’t. I can see how small businesses think it’s unfair; “corrupting the industry” is another matter, in my opinion.

@Ariel-Li if he is a person you care about as a friend or mentor, I might suggest buying him lunch and talking about his perspective, if you’re so inclined. If he’s just simply someone you used to work for who is grumbling, probably best to just let it roll off your back and keep doing your thing.

 

[CalliopeDVM]

I can see how small businesses think it’s unfair; “corrupting the industry” is another matter, in my opinion.

I don't know about corruption, but I do think it's negatively affecting the profession now and in the future, by taking more and more control out of the hands of more and more vets. Regardless of whether the intentions of the corporations are good or not, it does relegate virtually all vets to the status of employees, whether that's what they strive to achieve or not. And, in some cases, it requires them to accept responsibility (as medical director, for example) for things over which they have limited (if any) control - also a bad situation.

 

[that redhead]

And, in some cases, it requires them to accept responsibility (as medical director, for example) for things over which they have limited (if any) control - also a bad situation.

Out of curiosity - What would be an example of this?

 

[CalliopeDVM]

Out of curiosity - What would be an example of this?

Having insufficient or insufficiently trained staff, for instance.....It's the vet's license on the line for problems in surgery, as an example, even though they don't have the responsibility to control their staffing (quality or quantity). That could also apply to medical equipment (which corporate may or may not allow), and to pharmacy shelves. Additionally, medical directors will have controlled drug responsibility, even though they may not have control over who or how the drugs are handled (including ordering and shelving), or over what kind of safe they are kept in.

 

[Minnerbelle]

Having insufficient or insufficiently trained staff, for instance.....It's the vet's license on the line for problems in surgery, as an example, even though they don't have the responsibility to control their staffing (quality or quantity). That could also apply to medical equipment (which corporate may or may not allow), and to pharmacy shelves. Additionally, medical directors will have controlled drug responsibility, even though they may not have control over who or how the drugs are handled (including ordering and shelving), or over what kind of safe they are kept in.

I mean these are issues that apply to any associate. It is for sure not any better in this regard as an associate in private clinics. Are there some private clinics that do this well? Yes, but there are some corporate practices that do this well too. And there are clinics in both types that are nightmares. So essentially you’re underscoring that there are fewer opportunities for those who want to be practice owners due to corporatization of the profession.

But i dunno, the vast majority of people I know have 0 interest in owning a practice. So this isn’t really an issue for a lot of people. Those who do have been able to start their own practices and are doing well. It’s true there are fewer and fewer established practices to buy due to most selling to corporate, but at least in the current climate, start ups have the potential to do really well. (And honestly as long as you are in a good location, during an economic downturn the private practices that charge a little less than corporate can do well too). There are certainly a population of vets who are super anti corporate that will work at these practices. And the same can be said for clients.

And it’s totally fine for people to be anti-corporate for whatever reason. I think a lot of it has to do with personal experiences with ****ty hospitals in one camp or the other. But I’m not sure I’m seeing true arguments that exclusively apply to one side or the other (or even majority of the time).

 

[DVMDream]

I think the problem here is the question was asked about non vet owned practices and everyone is lumping private vs corporate. Yes, a good chunk of private practices are vet owned, but I've worked in private non vet owned practices and it was horrible.

The vet owned private practice I did relief at, I never met the owner. I came in as solo relief working by myself in their clinic. They had a great set up, great team, great clinic, properly spaced appointments, respectful clientele... it was a wonderful experience. Wish I could've met the owner, but that's the whole purpose of a relief vet, the other vet or vets can't be there.

So comparing private to corporate isn't addressing the question since they're asking about vet owned vs not vet owned. I worked for a vet owned corporate that was a mixed bag of ok and awful.

I think the answer is like everything else in life.... you have good and bad in both groups and your personal experiences will probably vary from others' personal experiences.

 

[CalliopeDVM]

So essentially you’re underscoring that there are fewer opportunities for those who want to be practice owners due to corporatization of the profession

Yes; it might not matter to the vets you know (and I never want to own a clinic either), but I do know of more than a couple of vets who want to own a clinic but can't afford it because corporations can pay that much more. So, it's narrowing the options that the profession can offer, and I think that will ultimately hurt the profession. Not that "the profession is doomed" kind of thing, but I do think it's not a good thing.

 

[Minnerbelle]

I think the problem here is the question was asked about non vet owned practices and everyone is lumping private vs corporate. Yes, a good chunk of private practices are vet owned, but I've worked in private non vet owned practices and it was horrible.

The vet owned private practice I did relief at, I never met the owner. I came in as solo relief working by myself in their clinic. They had a great set up, great team, great clinic, properly spaced appointments, respectful clientele... it was a wonderful experience. Wish I could've met the owner, but that's the whole purpose of a relief vet, the other vet or vets can't be there.

So comparing private to corporate isn't addressing the question since they're asking about vet owned vs not vet owned. I worked for a vet owned corporate that was a mixed bag of ok and awful.

I think the answer is like everything else in life.... you have good and bad in both groups and your personal experiences will probably vary from others' personal experiences.

Wait, didn’t OP literally ask for opinions about how their boss expressed concern that big corp was ruining the profession?

 

[DVMDream]

Wait, didn’t OP literally ask for opinions about how their boss expressed concern that big corp was ruining the profession?

Yes, but in her second post asked this specifically:

I agree with this on principle. However, do you have any examples where non-medical ownership hurts the interest of veterinarians and/or clients?

 

[pinkpuppy9]

because corporations can pay that much more.

They *can* pay more, but don't always. From my perspective, corporations (or maybe just my corporation...) are driving up the costs of care while driving down wages for non-DVM staff across the country. Big companies can attract people with the big sign-on bonuses, but their turnover is going to end up being high once those contracts expire. It feels good to get $5,000 until you realize you are getting your ass handed to you daily for $15/hr.

My company in particular (we are already the most expensive place in town) raises prices at least 1-2x/year with no subsequent pay raises for hourly or straight-salary DVM staff. We are hemorrhaging nurses, and some of my best, most capable nurses are leaving the field entirely (with some actually studying to go into human nursing).

Corporate has pros and cons. I had a huge long posted typed out, came back today, and thought I had posted it and it is gone lol. It really depends on which company you are looking at, and also what position you will have. Sometimes it also depends on what location you are at within that company. For example, my company pays ER doctors on production in some areas, in other areas like mine we are on straight-salary.

Having insufficient or insufficiently trained staff, for instance.....It's the vet's license on the line for problems in surgery, as an example, even though they don't have the responsibility to control their staffing (quality or quantity).

We are losing capable nurses so fast that we are hiring anyone with a pulse to work in our ER/ICU. Because of this, I currently am dealing with a case that may or may not result in a board complaint - new nurse ignored my dilution instructions and went rogue, and the patient may or may not have ben fluid overloaded as a result (may or may not, because I can't definitively say for sure). Nurse later that night also was not appropriately monitoring the dog, so we don't even know when things went downhill for sure. I had no hand in hiring or training these nurses or determining whether or not they could handle our arguably most difficult positions (ER and ICU). Yet, I'm the one whose license and professional reputation may get trashed

A benefit of corporation in situations like this is I basically just sit and wait now - it's out of my hands. They have lawyers on retainer for this. If my high up management can't smooth this over and make this disappear, then I've got big lawyers ready to take over. All with me doing nothing but waiting (and stressing...).

 

[DVMDream]

I just find it disheartening that veterinary care is getting so expensive that even DVMs can't afford it. Like I dropped $4k on my cat (luckily I had that), but that was with a professional discount. And I'd happily pay it again but I mentioned it to another colleague and she mentioned there's no way she could afford that.


And don't get me wrong, I think we all deserve better pay, hours, etc which means that has to come from somewhere. But we've shot ourselves in the foot in the process. Some of that is because of the large student debt, but, really that can't be solely blamed for increasing costs. I sure do see CEO salaries for the big corps increasing a lot over the years.


I don't know what the solution is but salaries aren't increasing at the rate that the increase in cost of care is and they should be. Until they do start increasing, we'll continue to see the giant flow of people leaving the profession.


And most private DVM owned practices can't afford big increasing salaries or $20-50k sign on bonuses. Because they do tend to keep costs lower than the big corporations, so they simply can't afford to pay what big corporations can, they don't have near as much income. Sure they could increase prices but I think a number of them don't necessarily want to, they still want the average person to be able to afford a pet. So they are going to eventually be brought out or replaced by the big corporations. You'll still get a few vets opening clinics and giving it a go, but they will continue to get smaller and smaller and smaller in number.


I honestly see vet med heading very much into human medicine similarities but without the same salary. Pet insurance will take over. You'll have veterinary mid levels (they're already discussing/pushing for this).


It is just sad, in my personal opinion.

 

[CalliopeDVM]

They *can* pay more, but don't always. From my perspective, corporations (or maybe just my corporation...) are driving up the costs of care while driving down wages for non-DVM staff across the country.

I meant that they can pay more (than an individual vet) to buy a clinic. I wasn't referring to salaries, or what they spend on equipment or improvements, etc.

 

[DVMDream]

Here it is... veterinary mid-levels. And they'll get even less training than a CVT/RVT/LVT... but can supposedly diagnose and do minor surgeries.

Welcome to the new vet med, where DVMs aren't hired as much and are replaced by the mid-levels but the cost remains the same and the DVMs that are hired have full clinical responsibility for the mid-levels. Good luck protecting your license.

Master of Veterinary Clinical Care


I'm honestly more concerned for finding care for my own pet now that I'm really not in clinical medicine. It'll turn into human medicine where you can't actually see a Dr anymore. Rather sad. This will put animals at risk and there will be many more medical deaths.

 

[TheDogFather]

Given that 85% of what we do is pretty routine and that technicians are capable of 85-90% of what we are its easy to see the potential proliferation of these programs. The chance to expand their bureaucracies, add tuition $$$$, and expand facilities will be irresistible to vet school administrators. It will be interesting to see what becomes of this vet "shortage", signing bonuses, and shortened work weeks as more schools pursue this avenue.

 

[battie]

As far as veterinary mid-levels go, my main question would be the money to pay them. We as veterinarians and veterinary technicians all agree they're under compensated. How much would these mid-levels be paid? 60k (dead center between what my techs make and my base)? I can't see 60k being worthwhile to technicians to go back to school for another 2 to 4 years for another degree for what I imagine it would cost.

 

[TheDogFather]

The "mid-levels" will just replace DVMs. It doesn't take a lot of training to manage sneezing cats, ear problems in dogs, dental cleanings, most mass removals, lacerations, diarrhea, etc.

 

[battie]

The "mid-levels" will just replace DVMs. It doesn't take a lot of training to manage sneezing cats, ear problems in dogs, dental cleanings, most mass removals, lacerations, diarrhea, etc.

My question is at what salary cost. Techs don't like their average yearly income of 30-50k/year, and docs don't like their 60-100k/year (obviously depending on work and region). What would mid levels be paid to make educating them but removing docs altogether? I mean, no tech in my hospital would go back to school to become a mid level for an additional 2-4 years just to make 60k at the end of it.

If the goal is to pay a provider less than a doctor, there's really not a great sweet spot between a technician and doctor. Especially compared to human medicine where a med assistant is paid the same as our techs, our docs are paid the same as their nurses, and their docs make more than everyone.

 

[DVMDream]

The "mid-levels" will just replace DVMs. It doesn't take a lot of training to manage sneezing cats, ear problems in dogs, dental cleanings, most mass removals, lacerations, diarrhea, etc.

Yes it does take a lot of training to manage those things. I'm going to guess, you aren't a DVM, given your new member status. Bet $1000 you're posting this trying to troll and get a reaction.

 

[DVMDream]

Given that 85% of what we do is pretty routine and that technicians are capable of 85-90% of what we are its easy to see the potential proliferation of these programs. The chance to expand their bureaucracies, add tuition $$$$, and expand facilities will be irresistible to vet school administrators. It will be interesting to see what becomes of this vet "shortage", signing bonuses, and shortened work weeks as more schools pursue this avenue.

Techs are capable of some of what we do, you're stretching at 85-90%. They aren't capable of that much of what we do, considering >50% of what we do is client communication and anytime that gets mildly difficult the techs come running for you to take over, yeah, no, they can't do 85-90% of what we do.

 

[TheDogFather]

Make it $5,000 and I'll take that bet. Anway, we just won't see eye to eye on the training required to handle most of what we see in general practice. How long does it take to teach someone to prepare and interpret an ear or skin cytology, (provided you even do them)? Sneezing cats? Try this antibiotic, sure we could test for one of the feline viruses (easy to do). If it persists we can sedate and look for polyps--maybe. Or, just let it be. Dental cleanings? Technicians are already taught to do that. Itchy animals: skin scraping/cytology (maybe), a food trial, Cytopoint/Apoquel/(Heaven forbid--a steroid)--then referral. Stifle lameness--reflexive referral for a TPLO. Obviously, the powers that be at LMU and other institutions feel that "mid-level" practitioners can handle these things.
As far as our wager goes, I'm willing to pay you $5,000 if I am not a vet, provided you agree to pay me $1,700 if I am. Why $1,700? I just ordered two $850 refurbished pen drive handpieces (sagittal saw and microdrill) for my well-used Stryker power console--all purchased from Didage Surgical Power. I can provide the invoice if you need proof. I can back that up with a letter from UMI Ultrasound for two phased array and one low-frequency convex probes to add to our machine (a Mindray Elite 8). I'll throw in proof of renewal of my liability insurance with Safehold. If that isn't enough, I suppose I can get you a copy of my license. Virtual handshake?

 

[TheDogFather]

As far as veterinary mid-levels go, my main question would be the money to pay them. We as veterinarians and veterinary technicians all agree they're under compensated. How much would these mid-levels be paid? 60k (dead center between what my techs make and my base)? I can't see 60k being worthwhile to technicians to go back to school for another 2 to 4 years for another degree for what I imagine it would cost.

 

[TheDogFather]

I doubt anyone involved in considering these "mid-level" programs really thinks through how those people will be paid. I think its more of a way to appear do be "doing something" about this "shortage". $200,00, $300,000, and even $400,000 debt loads have not slowed vet school applications. Why would lower debt stop anyone from considering entering the veterinary field via the "mid-level" route? When I entered vet school back in 2006, administrators, instructors, and hangers-on were bemoaning the "shortage" of rural veterinarians. They still are. I've not read of any attempts to streamline veterinary training to bring down the costs of practicing in rural areas or inner cities. All efforts go into seeking financial gadgets, big donors, or ways to finagle the taxpayers into covering the cost of vet school. Grave concerns are expressed, "strongly worded" letters are published in professional journals, some in the veterinary community are deeply troubled about the lack of care in remote areas--and it stops there. If these "mid-level" programs take off, students will do their time, pay their tuition, get their degrees, and be told to practice excellent medicine and to "charge what they are worth". Then the next class will enter to rinse and repeat.

 

[Trilt]

I doubt anyone involved in considering these "mid-level" programs really thinks through how those people will be paid. I think its more of a way to appear do be "doing something" about this "shortage". $200,00, $300,000, and even $400,000 debt loads have not slowed vet school applications. Why would lower debt stop anyone from considering entering the veterinary field via the "mid-level" route? When I entered vet school back in 2006, administrators, instructors, and hangers-on were bemoaning the "shortage" of rural veterinarians. They still are. I've not read of any attempts to streamline veterinary training to bring down the costs of practicing in rural areas or inner cities. All efforts go into seeking financial gadgets, big donors, or ways to finagle the taxpayers into covering the cost of vet school. Grave concerns are expressed, "strongly worded" letters are published in professional journals, some in the veterinary community are deeply troubled about the lack of care in remote areas--and it stops there. If these "mid-level" programs take off, students will do their time, pay their tuition, get their degrees, and be told to practice excellent medicine and to "charge what they are worth". Then the next class will enter to rinse and repeat.

I mean, realistically the fact that this degree comes from LMU tells you enough. A school that pays lip service to "rural veterinarians" while charging 50k a year for tuition? Give me a break.

This program is charging people thirty grand for a degree that does very little at this point. Honestly, it feels a bit like my own schools non-thesis Masters of Physiology, which basically mostly exists to show that people can handle master's level coursework and gives them something to do for a gap year.

An established mid-level is extremely hypothetical right now and would likely only be licensed (whenever a license exists) on a state by state basis, so opportunities to use this "new professional" title is going to be super limited and also really limit the individual's mobility in the future (even if this was arranged with a particular state in mind, which I think I saw @LetItSnow hypothesizing about elsewhere).

Personally I'd very much like more reasonably priced, widespread RVT/LVT programs instead.

 

[battie]

I mean, realistically the fact that this degree comes from LMU tells you enough.

It was either LMU or Midwestern that encouraged a pre-vet student they rejected for their CVM to apply to their pharmD program. Wasn't surprised, but still extremely rude.

Personally I'd very much like more reasonably priced, widespread RVT/LVT programs instead

The local "big name" CVT program in my area charges 30k/*year* for their associates. My bachelor's degree cost less even without my scholarships.

 

[TheDogFather]

I mean, realistically the fact that this degree comes from LMU tells you enough. A school that pays lip service to "rural veterinarians" while charging 50k a year for tuition? Give me a break.

This program is charging people thirty grand for a degree that does very little at this point. Honestly, it feels a bit like my own schools non-thesis Masters of Physiology, which basically mostly exists to show that people can handle master's level coursework and gives them something to do for a gap year.

An established mid-level is extremely hypothetical right now and would likely only be licensed (whenever a license exists) on a state by state basis, so opportunities to use this "new professional" title is going to be super limited and also really limit the individual's mobility in the future (even if this was arranged with a particular state in mind, which I think I saw @LetItSnow hypothesizing about elsewhere).

Personally I'd very much like more reasonably priced, widespread RVT/LVT programs instead.

I understand your take on the degree coming from LMU, their supposed emphasis on rural veterinarians, and their tuition. I'm just not exactly wowed by the established programs paying their own lip service to outlandish tuition, this shortage and that underserved segment of the pet population all the while doing exactly nothing to increase the practical proficiency of graduates or providing increased access to more advanced training to vets in the field. There's plenty of money for $300,000 deans, $250,000 assistant deans, $200,000 assistant deans of outreach and engagement, multiple six-figure assistant assistant deans of student life, equity and inclusion, and whatever else. What you won't find, at least to the best of my knowledge, are hands-on ultrasound labs with sonographers to get students feet wet, more actual practice surgeries (not of the "human retractor" variety with which we are all familiar), that sort of thing. That has little to do with corporate vs. private practices but in general, I don't think we can keep asking clients to pay more without offering more as individual vets--not referring everything up the ladder to more expensive practitioners. I do think that well-placed corporate money, like sending the aforementioned administrators to all-expenses paid "summits" in Las Vegas and Hawaii can go a long way in convincing the schools that the mid-levels can pretty much handle ear problems, itchy dogs and cats, mass removals, basic imaging, etc. and refer more complex problems to the same specialists that we GPs have been trained to rely on and increase profits to the parent corporations.

 

[Trilt]

I understand your take on the degree coming from LMU, their supposed emphasis on rural veterinarians, and their tuition. I'm just not exactly wowed by the established programs paying their own lip service to outlandish tuition, this shortage and that underserved segment of the pet population all the while doing exactly nothing to increase the practical proficiency of graduates or providing increased access to more advanced training to vets in the field. There's plenty of money for $300,000 deans, $250,000 assistant deans, $200,000 assistant deans of outreach and engagement, multiple six-figure assistant assistant deans of student life, equity and inclusion, and whatever else. What you won't find, at least to the best of my knowledge, are hands-on ultrasound labs with sonographers to get students feet wet, more actual practice surgeries (not of the "human retractor" variety with which we are all familiar), that sort of thing. That has little to do with corporate vs. private practices but in general, I don't think we can keep asking clients to pay more without offering more as individual vets--not referring everything up the ladder to more expensive practitioners. I do think that well-placed corporate money, like sending the aforementioned administrators to all-expenses paid "summits" in Las Vegas and Hawaii can go a long way in convincing the schools that the mid-levels can pretty much handle ear problems, itchy dogs and cats, mass removals, basic imaging, etc. and refer more complex problems to the same specialists that we GPs have been trained to rely on and increase profits to the parent corporations.

I mean, I can only speak for my school, but between the teaching and opportunities I was able to arrange I felt very adequate going into practice as a GP. My bosses never complained about me, lol. I transitioned easily to ER medicine after a couple of years, and while a lot of that was self taught and motivated, I feel like I had a good base from school despite being a fairly crappy student.

I specifically have worked in practices slightly outside of large urban areas because I enjoy the "jack of all trades, master of none" component of veterinary medicine and *not* referring everything. While our professors obviously always recommended offering gold standard, referral level care, with only some exceptions they were also enthusiastic about saying that we could handle way more than we thought and that often we were the only doc for that pet.

For your specific examples: I wasn't certain if I'd have ultrasound in practice so didn't seek out ultrasound opportunities, but we had an ultrasound rotation with the radiologists, did FAST scan stuff on ER, and they routinely had ultrasound training courses for GPs in the area that student pets were used for that we could hang out at as much as we wanted. We also had a fab terminal surgery lab (on pigs) where we did gastrotomy, enterotomy, splenectomy, etc. I had lots of opportunities to arrange spay/neuter experience in the area with a local rescue and with our mobile unit, then had space in my fourth year to get humane alliance trained and spend more time with another shelter... I had done over a hundred surgeries at graduation. Obviously mostly spay/neuter, but a spattering of others, too.

I'm rambling a bit, but my point is that I think you might be slightly more doom and gloom about available opportunities in schools for people who are interested in them. My goal was always to graduate as a reasonably competent vet at d1, and I think I was very much able to do that with my school.