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IDEXX: Contributing to something bigger

In the mid-1990s, I embarked on a journey to add an MBA degree to my credentials, to pair it with my DVM degree. Back then, it was an odd thing to do; my classmates seemed to think so. My interest was largely based on finding ways to make a veterinary career more economically feasible. Frankly, I struggled to accept the projected income I would make compared with the time, effort, and expenses required to become a veterinarian. A negative return on investment (ROI) didn’t sound any better in the 1990s than it does today.

With an MBA degree in hand, I thought I would be able to help solve some of the profession’s economic woes or at least work in that direction. A major theme in my MBA thesis centered on the supply and demand of veterinarians and veterinary services. At the time, a surplus of veterinarians existed, and management articles talked about the inefficiency of a veterinary practice on every street corner. Most of these practices were equipped with an x-ray machine, surgery suite, and full in-house laboratory. Additionally, unlike most medical and dental practices, veterinary practices were not booked in advance 2 to 3 weeks or more. The reality was that most of these 1- and 2-doctor practices were booked to maybe 75% capacity. Inefficiency abounded, directly correlating to poor veterinary compensation.

The argument espoused in my thesis paper was that we needed to turn the tables on the supply and demand for veterinary services. Until that occurred, veterinary compensation for the entire team would remain very low. To me, it boiled down to the simple math of splitting the pie. For example, if the revenue for veterinary services in the United States was $5 billion and there were 50,000 veterinary practitioners, the average practicing veterinarian would have a compensation of $100,000. If the demand for veterinary services rose to $10 billion and the number of veterinarians held steady, each veterinarian’s income would rise more appropriately to $200,000.

Flash forward to the 2020s. Many in the profession argue there is a shortage or severe shortage of veterinarians. Others do not fully agree, arguing there is widespread inefficiency within the profession. This inefficiency leads to the redundancy of veterinary facilities and ineffectiveness of doctors’ practice habits, which fail to fully use team members or leverage technology.

Supply and demand for veterinary services have fundamentally changed over the past 5 to 10 years. This presents its share of challenges and opportunities. Yes, it is difficult to find and keep team members, doctors, and staff. Yes, it is painful to turn clients away because you can’t fit them into the schedule. Yes, it’s difficult to skip continuing education opportunities because you don’t have time to attend. Yes, it is as difficult as ever to deny services to clients who don’t have sufficient funds. These are just a few challenges that have become reality.

If the veterinary health care system weren’t broken, then you could argue against changing it or celebrate the past. The reality is that it has not been an overly viable system for a long time, if ever. What other health care professions have had an ongoing negative ROI for their practitioners? Being a veterinarian is wonderful. But it is less wonderful when you understand that you are paying for the right to be one.

However, painful as it may seem, the perceived shortage of veterinary services has the potential to shape the future of veterinary practice in positive ways, leading to an overall better pet health care system for all stakeholders. The high demand for veterinary services is fueling the rapid evolution of the profession. Areas of major impact, when handled properly, can lead to greater practice efficiencies, more accessible pet care, and more appropriate compensation for the veterinary care team. The result is a more viable and enticing profession, which is long overdue. Areas of major impact will be as follows.

Veterinary practices will not be flush with staff in the foreseeable future, so focusing on efficiency in all areas of practice management is a top priority. It won’t involve simply creating a few time-saving steps but rather developing a culture of efficiency. Systems that allow doctors to see more clients promptly will be key to meeting the needs of clients and their pets.

The structure of the profession will change with more large, multidoctor practices and fewer small practices. A wave of practice mergers, part of the overall consolidation of the profession, will help enhance practice efficiency and profitability. For example, 1 practice of 6 to 8 doctors rather than 4 practices of 2 doctors each reduces redundancy in many areas, starting with fixed costs such as rent, utilities, and the general occupancy cost. Equipment costs are another key area of savings. Sharing an x-ray machine, ultrasound machine, and in-house diagnostic laboratory, rather than having 4 sets of the same technology, provides a significant boost to the bottom line.

The fight for veterinary team members is real and intense. It is partially fueled by the plethora of multipractice groups that want to avoid dark days and need to pay a premium to keep their doors open during business hours. The reality of wage inflation is difficult for practices to keep pace with, but it does drive practices to be more efficient and raise prices, supporting higher wages.

Cost of care is always a challenging topic, but fees need to be at a level where staff can be appropriately compensated. Veterinarians should be on par with similarly educated health care professionals. Over the near term, look for large increases in prices, which demand for services will support.

Expect to see an increase in veterinarian production of revenue and correlated compensation due to the supply and demand pressures. Although $500,000 to $600,000 has been standard production for the full-time veterinarian over the past 5 years or so, this will likely rise to $750,000 to $1,000,000 per year, driven by the need to see more patients to meet the needs of current clients.

Significant strides are being made with client communication tools that cut down on staff interaction time with clients. Reminder systems, preappointment information, questionnaires, 2-way texting, and more robust pet portals are examples that free up valuable team time. 

Cloud-based practice software programs can enhance and speed up the pet exam and associated medical notes, invoicing, and prescription writing processes. Remote management of cases is another tremendous advantage realized by doctors and hospital management.

Telemedicine came into its own during the COVID-19 pandemic. Providing a percentage of virtual clinic appointments and follow-ups creates great efficiencies for both practices and clients.

The creation of certified midlevel veterinary practitioners, equivalent to nurse practitioners and physician assistants in human medicine, is a must. These highly trained assistants can take a portion of the caseload off the doctor-only schedule and effectively increase veterinary services to the public. This efficiency will help keep pet health care costs down, because many cases and procedures can be handled by midlevel practitioners. Expect pressure to be put on the veterinary community to develop this position; it’s conceivable this will take place over the next 3 to 7 years. The formation of this position will be an extremely important step in the evolution of veterinary care.

Insurance, care packages, and compassionate care

Pets are part of the fabric of American society. Money spent on pets has traditionally been deemed discretionary, but that perception has largely changed. Pet parents are increasingly grasping the idea that it’s not a matter of whether a pet will get sick or need urgent or emergency care but more a matter of when. More than ever, pet parents are considering the best ways to prepare for unexpected events.

Supply and demand pressures are forcing veterinarians to price services where they need to be to maintain a viable, profitable practice. Clients are quickly reaching a threshold where they realize they need to budget for pet care the way they do for human health care and automobile and home insurance.

Over the next 5 to 10 years, wellness care packages and pet insurance will grow substantially in this country. There are more than 25 pet insurance companies in the United States, and they feel the tide coming. Europe is a good model for the future, with many countries having 25% or more of their pet population insured compared with approximately 3% in the United States.

A sign of positive change in this regard is that US companies of various sizes are starting to offer payroll deductions toward discounted wellness and insurance plans. They understand how important pets are to their employees and encourage them to budget for this care.

Health care for humans and pets is costly. At the same time, pets are good for the health of humans. Rising costs make it more difficult for many individuals to own pets, which is a major responsibility. Enhanced efforts of shelters and low-cost care groups help bridge this gap to a degree. Donations to groups that provide grants for pet care are on the rise, and these groups will be an important source of funding for the future. Veterinary hospitals can also join in this effort by providing compassionate care funds to help offset some expenses for the client who needs it.

In this regard, clinics can provide a degree of funding to assist clients in dire need of financial assistance. They can also help raise additional funds and donations from their general clients and partner with pet charity groups.

There is no lack of challenges or changes in the foreseeable future for the veterinary profession and veterinary professionals on the front line. How we respond to these challenges, however, will have a big impact on the profession and pet care in the future. Fortunately, with persistence and planning, meaningful positive changes can take place. These changes can help build a stronger, more viable profession for future generations of veterinary professionals and the pets and pet parents we serve.

, is the founder and copresident of Mission Veterinary Partners, headquartered in Novi, Michigan, which operates more than 250 veterinary hospitals in more than 30 states. He is a frequent presenter at veterinary conferences and veterinary schools and can be contacted at jeff.rothstein@ mvetpartners.com.

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Following the 2023 Veterinary Meeting & Expo (VMX), Jenna Dockweiler, MS, DVM, DACT, CCRT, CVAT, told 

 about the lastest technology and products for genetic testing. Plus, she explained how to communicate to clients how the tests work.

The following is a partial transcript of the video.

Jenna Dockweiler, MS, DVM, DACT, CCRT, CVAT:

 We have just started using what's called a methylation array, or a methylation chip. So this is a different type of technology than what we use when we are typically genetically screening patients. This type of technology we currently use it for our age test, which estimates calendar age. But it does have the potential to find new marks for disease and help us better understand DNA regulation. 

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The veterinary community is changing at a rapid pace. One of the pain points brought up lately is compensation for the veterinary team. Surprisingly, compensation is not the biggest stressor or reason that employees leave.

 Yes, everyone needs to receive a reasonable wage for their duties and skill sets. If you’re not actively meeting with team members, reviewing their results, and adjusting compensation based on inflation and their contributions to the practice this is one of the first places to start. Too many practices fall into the category where the team does not know where they fit within the overall vision of the practice and how their efforts contribute to the overall practice success. When the team member feels appreciated and knows their purpose within the practice, the focus on compensation becomes less of a conversation especially when the owner brings it up often.

There is so much attention brought to compensation because there are discrepancies with how people are being paid and, for the longest time, people would turn their eye. After someone is being compensated appropriately, there are many other things that get in the way to distract and make team members discontent. One of the biggest factors is their confidence on how to manage their day-to-day finances and be better prepared for the future. For the longest time people have been encouraged to get an education, go to college, and begin their career. But what about how to effectively manage finances?

We hear time after time that veterinary schools do not provide any or adequate amounts of financial education. Student loans are getting out of control and the guidance that students receive about how much they should borrow along with the future responsibility to repay those loans is brushed over. Student loans become a big part of people’s lives because they did not have the funds available to pay for education. The problem lies when there are no guidelines on what schools can charge and getting student loans is incredibly easy. Even technicians and others within a veterinary practice can be in a similar position where the amount they own in debt seems impossible to repay. 

With all this in mind, the best way to position your team is to make sure they have the proper tools to manage the daily pressures and to organized themselves to capture as much opportunity over time. There is a lot of emphasis to provide retirement accounts, health insurance, CE reimbursement, but not enough people talking about how to really impact and change the relationship people have with money.

There are programs available that can educate the team beyond just investing. Several plans have started to be introduced but it encourages people to invest, understand risk, but ignore most other critical pieces. This includes things like how they are protected in an automobile accident, an unexpected sickness or injury, random expenses that appear without an emergency fund, or how to save money, pay debt, and live a balanced lifestyle. There are about 19 major areas within someone’s finances and the focus is usually on 3-4 of them.

Financial wellness can be offered in many ways and the most effective is to actively provide something to the team. Yes, retirement accounts can come with basic retirement planning and investment knowledge. This is helpful for those who have done little within their finances. Where the bigger impact happens is when the owner actively promotes and encourages the team to participate. Here’s a sneak peek into some of the crucial areas that people should be reviewing and planning.

This is the one area that most people buy something and check the box without knowing the impact to them. The car company told them to get a set liability amount and “full coverage” on the vehicle. Work offers disability insurance, but they don’t know how much income it covers or what events will make someone qualify to start receiving payment. This is the one area where catastrophic loss can happen, and most people are dramatically under protected.

Most of society jumps into buying things like houses, cars, and enjoying life right from their first paycheck. The main emphasis gets placed on the day to day life and maybe repaying debt as fast as they possibly can. When there is little to no structure people tend to have underfunded emergency funds, worry about living check to check, and losing out on many opportunities in life.

We often get told debt is bad. But why is that? Debt is bad because it is often used inappropriately. Credit card offers are sent out constantly, borrowing money is easy, and people will try to enjoy those things in life without having any money yet. Debt is a good thing when used right and finding a balanced approach on when to use debt and repay debt is important.

The first place most people think about saving money is a retirement account. It might be from the constant propaganda telling people this where they save for the future. There are short, mid and long term goals that people usually do not have clearly defined. The 3 factors to consider when building assets are taxes, risk, and accessibility.

There are ways to implement this type of education to the team where it is readily available and where there are prescheduled times to provide one on one support. If you want to enhance the culture and reduce stress for your team this is one place that should not be ignored. The best place to start when improve the overall teams’ confidence about their finances is to offer them the tools. Finding the right resources and people to offer them is even more important. If you are in the position where compensation is a big issue, or you just want to provide more for the team then you should begin to explore financial education for the team.

Johnson S. 12 Secrets to Keeping Employees Happy Without a Raise. Business News Daily. January 23, 2023. Accessed January 25, 2023. 

Tom Seeko has worked with practice owners and veterinarians since 2014. He is the cofounder of Florida Veterinary Advisors that work with veterinarians throughout the United States, Certified Exit Planner (CExP), business and personal financial advisor, and cohost of the Smarter Vet Financial podcast.

This material is intended for general public use. By providing this content, Park Avenue Securities LLC is not undertaking to provide investment advice or a recommendation for any specific individual or situation, or to otherwise act in a fiduciary capacity. Please contact a financial representative for guidance and information that is specific to your individual situation. Guardian, its subsidiaries, agents, and employees do not provide tax, legal, or accounting advice. Consult your tax, legal, or accounting professional regarding your individual situation.This material contains the opinions of the author but not necessarily those of PAS or Guardian. registered representative and financial advisor of Park Avenue Securities LLC (PAS). Securities products and advisory services offered through PAS, member FINRA, SIPC. Financial representative of The Guardian Life Insurance Company of America (Guardian), New York, N.Y. PAS is a wholly owned subsidiary of Guardian. Florida Veterinary Advisors is not an affiliate or subsidiary of PAS or Guardian. Florida Veterinary Advisors is not registered in any state or with the U.S. Securities and Exchange Commission as a Registered Investment Advisor. The individuals associated with Florida Veterinary Advisors do not maintain specialized licenses or qualifications for the financial services provided to veterinary professionals. CA Insurance License #0K80141. 2022-142264 (Exp. 8/24)

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One of the crocodiles undergoing surgery at Zoo Miami (Photo courtesy of Ron Magill).  

Zoo Miami announced that its duo of highly endangered Cuban crocodiles, male Leroy and female Princess, were sedated and brought to its animal hospital where radiographs were performed to identify if there were foreign items in their stomachs.

 these exams were considered necessary when reports came in from patrons that a plastic bottle had fallen into the habitat. The bottle could not be found when staff members searched the area so they assumed one of the crocodiles ingested it. If naturally passed, this had the potential to cause digestive obstructions that could result in serious complications, and even be fatal.

Radiographs detected various small unidentifiable items in the stomachs of both crocodiles, with Princess having what appeared to be a large bottle cap. The team members used an endoscope to look in Leroy’s stomach, however nothing significant was discovered. Several fruitless attempts were made to use the endoscope on Princess, so it was agreed upon that because the foreign object was smaller in size, she would be closely monitored in hopes of passing it naturally.

Unfortunately, there have been other times that these crocodiles needed medical treatment for foreign items they have consumed. In 2019, Leroy required gastric surgery to remove a metal can and Princess had a plastic baby bottle removed with an endoscope.

 Zoo Miami animals have ingested everything from cell phones to sunglasses, causing substantial stress and at times, physical harm to these creatures. The organization stressed to zoo visitors to ensure their personal items are secure so animals do not have access to them and face dangers.

Cuban crocodiles undergo procedures to remove foreign items. News release. Zoo Miami. January 25, 2023. Accessed January 26, 2023. https://www.zoomiami.org/media-news/posts/cuban-crocodiles-undergo-procedures-to-remove-foreign-items

Plastic bottle fell into crocodile enclosure at Zoo Miami and posed threat to these creatures 

Cuban crocodiles receive surgery to extract foreign items 

Purina Pro Plan Veterinary Diets has teamed up with the American Veterinary Medical Foundation (AVMF) to help expand the AVMF Reaching Every Animal with Charitable Care (REACH) program. This program provides grants to American Veterinary Medical Association members in the veterinary field who offer immediate care at a low or no cost to pets with owners experiencing financial limitations.

 for each purchase made on Purina Pro Plan's VetDirect website from January 15, 2023 through June 30, 2023, Purina will donate $1 to the AVMF to support the REACH program. The company will contribute up to $200,000, so veterinarians don't have to make the difficult decision between their patients and their practice.

Financial hardship was exacerbated by the COVID-19 pandemic, however this has been a problem for some time. In a survey of veterinarians published in JAVMA in 2017, 77% of respondents reported that the economic limitations of clients (regardless of whether those limitations were by choice or necessity) were either a moderate or primary contributor to their level of professional burnout.

"Over the past several years, many veterinary practitioners have been riding a roller coaster of emotional and operational challenges in their practices, between working through a global pandemic, staffing challenges, and—most recently— inflationary pressures making it harder for clients to make ends meet," noted David Granstrom, DVM, PhD, DACVM (Parasitology), assistant executive director at AVMF, in the release. "The goal of the AVMF REACH program is to remove some of the difficult decisions practitioners must make when a client can't afford lifesaving care for their pet. Thanks to the donation from Purina Pro Plan Veterinary Diets, more of their answers can be 'yes' instead of 'no.'"

"Veterinarians today face so many challenges, from working extra-long hours to providing quality care for their patients to keeping their own staff members motivated. We believe this program not only honors the calling of veterinarians but will also directly alleviate some of the everyday stress practitioners feel as they make decisions regarding patient care," stated Jason Gagné, DVM, DACVIM (Nutrition), director of veterinary technical communications for Purina Pro Plan Veterinary Diets.

The REACH program has plans to expand eligibility criteria to go further than helping underserved clients affected by COVID-19, disaster relief, and domestic violence to those with more general financial needs.

Purina Pro Plan Veterinary Diets announces partnership with AVMF to support veterinarians. News release. Purina. Purina Pro Plan. January 26, 2023. Accessed January 26, 2023. https://www.prnewswire.com/news-releases/purina-pro-plan-veterinary-diets-announces-partnership-with-avmf-to-support-veterinarians-301731206.html

Kipperman BS, Kass PH, Rishniw M. Factors that influence small animal veterinarians' opinions and actions regarding cost of care and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout. 

. 2017;250(7):785-794. doi: 10.2460/javma.250.7.785.

Partnership supports veterinarians and helps pets in need through funds to the AVMF REACH Program

Purina Pro Plan Veterinary Diets joins forces with AVMF 

The Maryland Zoo has announced addra gazelle, Blanche, has given birth to calf, Jinx. The zoo’s gazelle herd now consists of 3 animals.

Jinx, the latest addition to the Maryland Zoo (All images photo courtesy of Maryland Zoo). 

“We’ve been keeping Jinx warm and dry in the barn to bond with her mom. She’ll make forays outdoors as she grows and the weather warms up,” expressed Erin Grimm, mammal curator at the Maryland Zoo, in an organizational release.

Addra gazelles (Nanger dama) are also referred to as the dama gazelle and mhorr gazelle. They make up the largest and tallest gazelle species. Native to Africa’s Sahara Desert area, these beautiful animals are critically endangered as a result of habitat loss and overhunting.

The birth was the result of a recommendation from the Addra Gazelle Species Survival Plan (SSP) coordinated by the Association of Zoos and Aquariums (AZA).

 SSPs offer breeding recommendations to promote genetic diversity, aiming to ensure the health of the individual animal, plus the long-term survival of the species population to help save animals from extinction.

The Addra gazelles can be found in the warmer seasons in the African Watering Hole habitat adjacent to the rhino, ostrich, and zebra.

Maryland Zoo announces birth of gazelle calf. News release. Maryland Zoo. January 24, 2023. Accessed January 25, 2023.

Critically endangered species in wild due to habitat loss and overhunting 

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