Well. I'm not going to touch on the historical aspects of the American economy because while it matters, it's a downward cause and effect that we cannot change. I honestly also don't have the knowledge to discuss them in depth.
Between the stars has nothing to do with vet med economics. That will be separated out. I'm unlikely to respond to any responses to the stuff in between the stars cause I don't really know what my feelings are in regards to the emotional discussion going on are.
*********
In regards to the actual emotional argument:
I also encourage everyone who has been around the forums for an extended period of time to find your way to the Sociopolitical Forums here on SDN. I'm not sure how to share it with y'all as it's something that is purposely hidden and very minimally moderated. There's a lot of political discussions there I think would do a lot of people good.
There's obviously miscommunication going on here for multiple people to feel attacked from each other. I honestly didn't read all of it because it was going nowhere. But intent of speech matters to me just as much as the response on the receiving end. I'm glad to see someone like
@Musicandhorses present to break up the monotony of thought I feel a lot of us share. If there's anything I've learned going through living in Denver, going to college in the middle of nowhere Nebraska, and going back to Denver, is there is a lot of variation of thoughts from one source across politics, religion, economy, etc. and pretty much none of them are entirely correct and what functionally works best is a mix of these different thoughts.
******************
VET MED ECONOMICS, SOMETHING I HAVE MORE CONFIDENCE TALKING ABOUT
So, like I stated in the thread started by the human medical director, the number one issue in vet med is the fact it is capitalistically driven. Our services are at the same level of a mechanic as the most common analogy I see. Even for people who don't drive, it still works cause our USDA and APHIS vets are similar to the mechanics that take care of city buses as an extension of that analogy.
Therefore, veterinary medicine is a luxury service industry. Animals are property (whether or not that's a bad or good thing is a whole other discussion, which can be had; im just not going to touch on that here). And so from an obligation standpoint, the client only has an obligation to seek an opinion on care and medical advice. As an emergency doctor, it is not uncommon for me to have people sign AMAs when they refuse treatment options, which includes euthanasia. I had a family take their dog home that was likely ITP for her to bleed out and die at home. And there is very little I can do about that. There are no consequences for these owners because 1) they sought vet care and 2) I cannot prove negligence or abuse. The dog was very well cared for otherwise, tbh, and it was apparent they loved here. But they could not afford treatment and did not believe in euthanasia. It is what it is. All I could have potentially changed is calling animal control on specific cases. I don't frequently because they ultimately don't have the time or resources to go to every case I would call in on.
Now, the majority of ER and specialty practices are owned by corporations, and most of those are venture capital or similar types of corporations. They infiltrated human med some time ago and they are ultimately driven by consolidation and streamlining services. I'm honestly not against that type of business model on its face because that does make things more efficient. However, the problem is that they corporations are driven by year over year increases in growth. The head honchos are paid a percentage of those increases. Unfortunately, in vet med, that's not a given because, as earlier stated, we are a luxury industry. People will pick us last after groceries and gas. Our oldest hospital has had quite a few DOAs lately. Home many of them are true DOAs vs animals that had been sick that never got help? Impossible to say. My hospitals are about 2 million below projections between the three of them. VCA closed a bunch of their urgent cares. Blue Pearl is trying to reduce costs. Corps are starting to feel the pinch.
Solutions? I don't know if privately owned practices are the end all be all. The two privately owned ERs in my area have a terrible reputation and a meh reputation. Both are poor enough that I havent jumped ship yet. I honestly have not had a positive experience in a privately owned hospital ever. Likewise, VEG is a corporation where the primary owners are the two ER doctors who owned founded it and they have a financial board. There are GP/Urgent Care combos (GoodVets, CityVet) that are franchise corporates that the DVM owns the local clinic down the street from me (a classmate actually owns it tbh).
Likewise, I grew up in a family owned business that was animal based. My grandpa's grandma started it in 1906. My grandparents got out in, like, the late 00s or early 10s. My mom was out in 2015. My aunt died, so out in 20. I have a few cousins who are still in it, and one is actually actively trying to change the industry, though I think that battle was lost 30-35 years ago. And what did I learn? Owning your own business, especially in family, can suck. While I had a good childhood overall, my mom being on call 24/7, my parents finances being completely tied up in the business (great recession left us in perpetual near homelessness for years with close calls that I missed at the time), and more was absolutely terrible. I am much more financially savvy than my mother or even my grandparents, and would very likely be a better business owner. And it's still a hard no to me. My sole exception would be if the leadership I'm currently losing would start a privately owned ER, then I would join as a silent partner potentially.
So that's the business side in a small nutshell, likely missing somethings. Maybe the person who runs the VIN foundation account can chime in. Going into vin and reading anything written by Tony Bartels or Rebecca Mears would be great too.
What about the school side?
Flat trash, that's what. But I'm leaving my coffee shop now and have to sign off for now. TTFN.
www.edweek.org
www.forbes.com
