Further indulge my Miami metaphor by envisioning our suppliers as the bottom half and elite specialty providers as toppers. We, the tender baby pig (arguably the least equipped to tolerate the pressures), are becoming but a smear of protein. To be sure, it's delicious in the end. Nevertheless, it's still kind of sad the bread ends up with more than its share of all the butter.
Culinary fantasies notwithstanding, it's clear things are getting tougher for the average veterinary practice. Increased ER income is keeping specialty services humming, while as many as a third of the practices in my area have temporarily shuttered, possibly never to reopen.