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5:14 AM   April 23, 2014
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When Corporate Practice Calls

By Bob Womack

When Brian Harpster, VMD, MS, owned a practice, his wife claimed he worked 90 hours a week, though he says it was actually 60 to 70. His West Shore Veterinary Hospital in New Cumberland, Pa., had a staff of 30 and grossed $1.7 million annually.

At 51, he wanted to reduce his hours and still practice while eliminating “the headaches and hassles” of management. In a decision he says was “50 percent lifestyle and 50 percent financial,” he and two partners sold the practice to VCA Antech in December 2002.

They sold for 11 times the hospital’s original cost in 1984, retaining ownership of the building and land with VCA agreeing to pay for future renovations. Carrying low debt, they could use VCA’s rent payments to defray the mortgage, which will be paid off next January.

After the sale, Dr. Harpster’s income was about the same, but his work week dropped to 40 to 45 hours. He now works 3 1⁄2 days a week, 32 to 34 hours, at what is called VCA West Shore Animal Hospital.

VCA, based in Los Angeles, operates more than 470 hospitals in 39 states, employing 2,000 veterinarians, including 200 board-certified specialists.

The growth of another large corporate practice, Banfield, the Pet Hospital, based in Portland, Ore., was fueled by its partnership with Petsmart. It employs more than 1,900 veterinarians at more than 720 hospitals nationwide.

VCA treats more than 1.5 million animals annually, com-pared to Banfield’s 4 million.

Independents Dominate
VCA, Banfield and smaller corporate practices make up about 5 percent of U.S. practices, says Dennis M. McCurnin, DVM, MS, Dipl. ACVS, professor of veterinary surgery and management at Louisiana State University’s School of Veterinary Medicine. He is also a veterinary practice consultant.

“Are they going to take over the practice of veterinary medicine? No, I don’t foresee that,” Dr. McCurnin says. “The average practice size is two (veterinarians).”

Todd Tams, DVM, Dipl. ACVIM, chief medical officer of VCA, says: “I talk to many veterinarians who express concern that ‘Large corporate groups are just trying to take over,’ but that’s not the case. There will always be a role for veterinarians who want to operate their own practice.”

The main reasons veterinarians sell to a corporate practice are “stress of ownership … and financial pressure. They’d like to get some money back out and cut back on their hours,” Dr. Tams says. “A lot of veterinarians think they’re burned out on veterinary medicine, but after six months, they often say, ‘I realize now what I was actually burned out on was the stress of trying to run all aspects of hospital operations.’ ” 

For new veterinarians, a corporate practice’s internship, mentorship and continuing education programs are draws, Tams says.

Beneficial Relationship
Rachele Wilson, DVM, who graduated from the University of Tennessee’s College of Veterinary Medicine in 2007, interned at a VCA hospital in Mesa, Ariz., then joined VCA Greater Savannah Animal Hospital in Georgia.

Dr. Wilson, 30, says her colleagues “are really interested in being up on all the new medical information out there, into continuing education, into being on the cutting edge.” She likes “working with other doctors and bouncing ideas off them.”

She also likes her work schedule—four days a week, plus one or two Saturdays a month—as well as her salary and medical benefits.

Even small corporate practices can offer good benefits because of their size, says Tim Smith, DVM, of InTown Veterinary Group, which has five hospitals in Massachusetts and New Hampshire. That helps attract more job applicants.

The groups also can “put buying pressure on vendors in a lot of markets” to get better prices, Dr. Smith says. 

“Corporate practice has probably been good for the profession as a whole,”  McCurnin says. “Private practices feel the pressure and have had to make sure to compete.”

West Shore’s Harpster says VCA is very astute about costs in managing his former practice. “Veterinarians in general are not astute business people,” he says.

Quality of care went up under corporate ownership, he says, citing the group’s emphasis on casework, patient follow-up, more diagnostic testing “and a strong tendency toward astute pain management.”

Some clients didn’t like the changes, but he notes, “Whether you sell to corporate or private practice, there will be changes.”

Cost of Improvements
When a corporation buys a practice, it often aims to “upscale medical quality to the high end of the standard of care,” Tams says. “We (at VCA) definitely want to practice a high level of care, and sometimes higher fees come with that.”

Wilson says she sometimes offers three estimates, based on different approaches, at the Savanna hospital. “It’s important to offer the best tests,” she says, “but you have to be under-standing of the fact that not everyone can afford them.”

A charge sometimes heard about corporate practice is that the personal touch is lost. “There’s something to that, but it depends on the people you have on board,” Harpster says.

Wilson says she likes the  “continuity of care. If you make an effort, it shouldn’t be a problem.” 

For her, the thought of setting up her own practice “when you’re buying a house and starting a family ... is too daunting.” She won’t rule it out, but the conditions would have to be right.

“I’m a perfectionist,” she says, “so I would have to be in control of everything—from the front desk to the financial aspects. I worry I would never leave to go home.” <HOME>

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