No, I don’t own a veterinary practice. I can give you a very long list explaining this lapse in my traditional vet career trajectory. And while on paper it’s a justifiable life choice, I’ll confess: Eschewing practice ownership doesn’t make me feel particularly virtuous or successful as a small-animal practitioner. I suspect the same is true of many of my ambitious colleagues. Here’s why I’ve opted out: Money: I attended an expensive school. I had big debts when I graduated (can you say $100K?). I moved to Miami, where almost half of my better-than-average vet income goes into my decidedly unluxurious home (really). And I’m a single parent. To invest in a practice, I’d have to sell my house—not a safe move in this real estate cycle and not a smart option when it comes to my child, either. Time: Let’s start with, “I’m a single parent” and pretty much leave it at that. Consequently, flexible hours are a requirement for my work. While I don’t mind putting in 80-hour weeks from time to time, it’s the inability to work from home (or work in the half hour here and there for school pickups and orthodontist appointments) that kills me. Fear of commitment: Life as a practice owner seems all-consuming. I want more from my life than a half-million dollar check in my bank account when I turn 65. Which is not to say this wouldn’t be desirable and laudable, but what would I have to give up? Would I be unable to explore other challenging sidelines to my career, like writing? Would I still be able to go kayaking in the Keys on Sundays? Though this list sings my own life’s story, conversations with peers echo its sentiments. And lest you think my colleagues similarly feminine in their tales of ownership woe, evidence to the contrary abounds. Most of my sub-40 male counterparts suffer practice ownership anxiety, too. If this rationale doesn’t resonate with you, you may share one or more of these practice ownership predispositions: • You graduated with little debt. • You live in an economically stable area and your income has grown steadily in favorably disproportionate contrast to your expenses. • You’ve always embraced the concept of practice ownership for its challenges. • You came of age in a culture where breadwinning was a huge measure of your personal worth. • Practice ownership was expected as proof of success in your profession. It’s true, respect for making money and proving your worth with a sizable financial undertaking hasn’t changed much in recent years. Practice ownership still confers significant advantages in terms of prestige and financial remuneration. That’s why those of us devoid of such an enviable position may feel frustrated and guilty over the prospect of putting off or abandoning the goal of ownership. Mergers are whence human practitioners sagely migrated in their quest for quality of life, stable economics and the efficient use of high-priced suburban real estate and wickedly expensive equipment. It doesn’t help that earlier generations of professionals express dissatisfaction with what they perceive to be our “slacker” ways in opting out of private practice. “What, you prefer to kayak with your family instead of meeting your financial obligation to them?” To some, my honestly expressed desire for a rich family life is proof positive that our profession is going to hell in a hand basket. My rejoinder? “If you had over $100,000 in debt when YOU graduated, you’d require regular bouts of stress-relieving exercise, too!” Yet it’s more complicated than that. Our culture has changed along with our profession’s economics. The synergy of these two forces has changed veterinary medicine as we know it. This complex shift in attitudes and finances has made way for the following: More corporate veterinary hospitals whose business plans rest on the opportunity that comes with an excess of independent professional mouths to feed. More specialists, many of whom select their field based not only on the potential for higher income but the opportunity to work in larger groups with the oft built-in opportunity for buy-in. Fewer small practices—with an attendant drop in value when it’s time to cash out. The possibility of a new generation of veterinarians who may end their careers financially dissatisfied because of limited investment opportunities in their profession. We can wring our hands over the first one and sing the praises of the high-tech savvy in the second, but it’s the third and fourth that really set the larger community of vets on edge, especially those approaching retirement age. It’s these colleagues who imminently face the prospect of a fire sale on their equipment as their clients vanish into the corporate vet vacuum or court neighboring mega-hospitals. Though I’m on this side of the divide for now, I well understand the fear of cashing out empty-handed. It’s the flip-side of what I currently face. Why wouldn’t it get my sympathy? So now that we understand one another, what are we to do? Sell what we can to the corporations at the highest possible price? It’s nice work if you can get it. But only a tiny percentage will meet VCA-style criteria. The WalMartification of the profession by the big-box retailers, however, means new clinics in strip mall anchor-stores are edging out traditional practices, ultimately culling the ready-to-retire and soaking up the free-agent associates in droves. There’s no sense bemoaning lost opportunities and dealing out blame in the wake of our profession’s changing economic mechanics. The solution is simple: Merge! Mergers are whence human practitioners sagely migrated in their quest for quality of life, stable economics and the efficient use of high-priced suburban real estate and wickedly expensive equipment. I’ll argue the same should be our own profession’s holy grail. Here’s why: Mergers can supply flexible work long past retirement age for would-be sellers; A larger client base for younger, ambitious hospitals looking to financially justify future expansion and investment; A place to invest for those who would otherwise never buy (like me) but who yearn for an investment opportunity and a deeper attachment to their place of work; The off-time and flexibility unavailable in start-up practice (including sabbaticals and family leave); The mentorship, familiarity and collegiality such a condition promotes among all invested parties. This is where the bulk of veterinary practice has belonged for the past 20 years. Yet our historical reluctance to forgo the traditional model (primarily for cultural reasons) has been the rub. This now-unrealistic attachment to traditional practice ideals is leading us into a perfect storm where professional dissatisfaction and unnecessary economic stress amass on both sides of the generational divide. The world has changed. The nest egg is no longer where we expected it to be. The stability we all crave has abandoned us just when our student loan payments are ballooning. Add in the mounting discord among these disparate groups and ours is a profession ripe for corporate picking—not to mention professional burnout and bankruptcy. Until now, the financial incentives of outsiders to veterinary practice have steered us away from the perceived “messiness” of mergers. Maybe now we’ll wake up and avoid the vultures by taking control of our own personal, professional and financial destinies. After all, even we slackers and kayakers are willing to work hard. We want practices, too! Call me Pollyanna, but fewer financially aimless grads, more satisfied practitioners and better compensated retirement-aged vets should be incentive enough for all of us to get on the merger track ASAP. What’s it going to take? Dr. Khuly blogs regularly at www.dolittler.com. <HOME>
