Should we incorporate ourselves?

Corporations and private investors are becoming a growing part of veterinary medicine.  What are the advantages and disadvantages of increasing numbers of corporate owned veterinary clinics? What are your experiences with this type of system, and will you or are you considering getting involved in corporate veterinary medicine in the future?  Why or why not?

Winner, Forum category
Becky Lee, UC Davis

 “Don’t work for them if you can help it.” This was advice I received from a vet working at one of the large corporate-owned veterinary hospitals. For some veterinarians, the reputation of these corporations can be dismal. In my personal experience, working for these corporations in the summers during vet school and on externships, I feel I’ve gained a general understanding of the pros and cons.  Although I try to keep an open mind, I have seen sides of the corporate behemoths that would make me think very carefully before signing a contract.

    I must admit that the compensation from some of these companies is very appealing, and the benefits they offer help keep our industry standards high. In some ways, I am grateful. This is important to us as students with our colossal loan debt. Of course, money is not the bottom line for us; otherwise, we would all be working on Wall Street or managing hedge funds instead of being vets and treating hedgehogs.  

    Large corporate-owned practices also have an abundance of resources. There is consistency in staff training and likely similar technology available between practices. If you are out of heartworm tests, you can drive over to your neighboring corporate location and borrow a few. Or if you have a staff member out sick, it’s probably easier to find a back-up technician as a substitute compared to working at a single, independently-owned practice. I also have to admit that I think wellness plans can be a good thing and encourage preventative medicine, so long as these plans are not rammed down the client’s throats, and the pets aren’t receiving unnecessary services.  Fortunately, I think the medical services provided with these plans have improved over the past few years. Lyme vaccine and tonometry, anyone?

However, despite the ample resources these corporations have, one issue that left a negative impression with me was the pressure to sell. “Were you sure to offer the wellness plan?  Did the receptionist, nurse and doctor all offer the plan to the client? Why aren’t you getting people to sign up for these wellness plans?” Questions like these were emphasized and re-emphasized by regional directors in their visits to the hospitals. In my opinion, the pressure to sell was much stronger in corporate veterinary medicine than compared to the independently-owned practices where I’ve worked.

    I had spent time at one corporate practice in a lower socio-economic neighborhood and seen people come in for free puppy exams and decline all vaccines due to financial constraints. Although this is an extreme example, it was not an uncommon occurrence at this practice.   You can imagine the degree of sympathy that regional directors had for these people and the veterinarians working with them. That’s right. None. The veterinarians were pressured by the higher-ups, and their low production was compared to the obviously much higher production of veterinarians at more affluent locations. Clearly, it had nothing to do with how much money people have; these veterinarians just needed to try harder.

    Another area of contention that a veterinarian mentioned to me was the controversial free initial visit coupon offered by their corporation.  I learned that veterinarians at that particular hospital had many experiences of first time clients bringing in critically-ill patients that should have been seen as an emergency days prior. Nevertheless, the owners had elected to wait for an open appointment so they could get their free exam.  In many cases, owners who brought in pets had no financial resources for diagnostics or treatment. Needless to say, the pet’s suffering was prolonged, and the learning experience for a new graduate was poor.

    As a new veterinarian, mentorship is of utmost importance, particularly during the first year. During my time spent with corporation ABC (well, let’s just call it corporation B to keep it simple), a recent grad was bounced between different hospitals during the week.  As a result, she had difficulty following-up with her cases and did not have consistent mentorship. Of course, this corporation offers an initial period of mentorship that is standard. However, for this recent grad, after that short period was over, her resources were severely lacking. This location-hopping also placed restrictions on scheduling her surgery time and limited her ability to improve these skills. Although she specifically requested more surgery time, I did not see any changes made to improve this during my two months there.

    In my personal experience, the doctors and the staff that I worked with at these corporate-owned practices were great. They were not robots, but real doctors practicing high quality medicine.   I can say that I respect them wholeheartedly. However, I cannot say that they were not pressured to produce. I also cannot say that these corporate policies did not stifle them to some degree. To be honest, the visits from regional directors to the hospital were dreaded by the staff. I found that their visits rudely disrupted the flow of the practice and detracted the veterinarian’s attention from where it belongs, on patient care.

    When I was a first year vet student, I once asked one of the graduating seniors who had spent summers working for one of the corporate giants if they would consider working for them after graduation. In response, they laughed and matter-of-factly replied, “No way.” Laughter is not always a good sign. More than three years later, as a fourth year about to graduate, I’ve had to ask myself the same question. As a new veterinarian, I do not want to juggle the pressure to sell with the chaos and stress that the first few months of practice can bring. Maybe this type of position would be better suited for someone who is not bothered by this aspect of the business. Maybe with the appropriate mentorship and the right personality, people can thrive in this type of environment. For me, there are too many ‘maybes’ for my liking.