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Alexandra L. Winter, BVSc (Hons), DACVS (Photo courtesy of Merck and Co.)

Earlier this month, Merck and Co. Inc, appointed Alexandra L. Winter, BVSc (Hons), DACVS, as the new editor in chief of 

—a trusted source for veterinary and other animal health professionals since 1955. 

In her new role, Winter will be tasked with leading an ongoing conversation with all relevant stakeholders, including veterinarians, students, animal owners, and industry professionals, about how to advance the health and quality of life of both animals and humans, according to a Merck release. “

, in all of its formats, will reflect these diverse perspectives," says Winter, in an organizational release.

Winter has an extensive background in innovation, interprofessional research collaboration, and medical education. She's also a member of the 

 Additionally, Winter serves as faculty for the Leading Innovations in Healthcare and Education course at the Harvard Macy Institute at Harvard University and is a member of several other professional veterinary organizations. Recently, Winter served on the Residency Program Compliance Committee for the American College of Veterinary Surgeons.

Articles

Dr. Alexandra L. Winter's core mission is to discuss strategies for advancing the health and quality of life of both pets and people with both veterinary and pet-owning communities.

Merck appoints new editor in chief of its renowned reference manual

” (March 2021) Karen Felsted, DVM, MS, CPA, CVPM, CVA, makes the following statement: “As the saying goes, your veterinary practice is worth what someone is willing to pay for it. However, if you’re trying to do some financial planning, that saying isn’t a very helpful or specific answer. Fortunately, better information exists.” While the article is helpful, it fails to elaborate on how the sale process can influence sale valuation. I think failing to do this does a disservice to veterinarians.

Most practice owners don’t get their practices valued regularly. For many, the price and time commitment is too high even if regular valuation could be a useful tool for business planning. Practice owners commonly get a valuation to “test” an offer to buy their practice. Depending on what the valuation shows, the veterinarian might accept the offer or ask for more money. The problem is that this is not the right process in which to sell a practice because there is no price discovery. The valuation one gets from Felsted and others, including VetValue (the company I founded), is just 1 data point, 1 opinion. Each potential buyer will value a practice differently, and a third party has no way of knowing where that valuation will land. Using an appraiser to decide whether to accept an offer in a sale process without price discovery almost always results in the veterinarian selling their practice for way less than it is worth. I see this happen every day.

I think all doctors would benefit from articles like this if they were more explicit about the appraisal result’s value as a predictor for what can be achieved by a committed seller using the correct process to sell their practice. Maybe a disclaimer: “Do not use an appraisal, or valuation, in lieu of running the correct sale process to sell your practice. If you want a valuation to prepare for a practice sale, please consult an expert.”

The primary focus of my article was the importance of profitability in driving practice value; the sale process Mr Taylor mentions was outside the scope of my article. Having said that, this certainly brings up a couple of important points worth considering:

Mr Taylor’s comments apply primarily to those who are interested in selling to a corporate group because there is a great deal of competition for those practices and multiple potential buyers. This isn’t true of most noncorporate sales; the concept of “price discovery” doesn’t exist in the same way because there are usually significantly fewer buyers for a particular practice.

The concept of obtaining multiple offers isn’t a new one; all the consultants I know who work with practices selling to corporate do this.

Getting multiple offers may not be as common among those sellers who handle the process themselves but should certainly be considered.

A response from one reader regarding a previous article on how to calculate your practice's value.

Reader feedback: The nuances of veterinary practice valuation

 context is everything. As I see it, there are several reasons why there are so few Black veterinary professionals today.

With regard to the purported historical rise of the Black professional class, it must be noted that the increase has not been nearly as robust for Blacks as for other minority groups since the Great Recession of the late 2000s. The relative increases that we see are primarily in joining the workforce of “non-elite” professions. Although a slight increase among Blacks joining “elite” professions (eg, physician, lawyer, engineer) was observed over time, that trend has not extended into senior leadership. This is borne out in the egregious underrepresentation of Black CEOs in Fortune 500 companies—the figure hovered around 1% as recently as 2019. Today, only 4% of doctors and 5% of attorneys are Black. So, we should be careful to highlight that all elite professions—not just veterinary medicine—suffer from underrepresentation of Black professionals.

Diversity and inclusion work best when implemented at all levels within an organization. Without diversity in leadership, minorities are more likely to feel disenfranchised. Moreover, they are less likely to have their ideas heard or, worse yet, not get credit for them. In this atmosphere minorities are passed over for promotions, underpaid, and less likely to be recruited. Continually, they are retained at a lower rate than members of the dominant group and are less likely to receive proper placement.

When Tuskegee University School of Veterinary Medicine was established in 1944, there were fewer than 6 veterinary schools in the United States and none of them allowed Black students to attend. Fast forward to today, there are roughly 5 times as many MD-granting institutions as there are veterinary medical schools. The natural conclusion is that because of the relatively small number of veterinary schools, acceptance into them is more competitive, thus leaving the schools themselves more vulnerable to the effects of racism and bias during the selection process.

Racism plays a role here because Black candidates who desire a career in veterinary medicine routinely get passed over by non-Black candidates. This occurs because Black candidates may not have attained the same level of success or experience leading up to applying to these institutions. The disparity in achievement can further be explained by the lack of access to the most rigorous college preparatory curricula and the unwillingness of members of the majority group to give jobs, internships, or mentorship opportunities to Black students.

Another reason for the extensive whiteness of our profession is the lack of representation of Black veterinarians. This may come off as circular reasoning, but let me elaborate. In the absence of broader societal images of Black Americans, stereotypes have a disproportionate impact. Stated differently, the low numbers of Black veterinarians limit the number of Black people aspiring to become veterinarians because of the lack of representation and access to Black veterinarians. It is far more difficult to aspire to be something when society tells you it cannot be done and when you have little to no reference of people who look like you, achieving that goal.

Lastly, we cannot overlook cultural differences and how Black people historically viewed the role of domesticated animals. For many years, racism has forced marginalized groups to feel like they are competing with one another for their piece of the pie, especially when society has determined that their access to that pie is already limited. When you are trying to make ends meet and provide for your family, you often do not have the luxury of caring for an animal according to the standards to which we are accustomed today.

The vestiges of this are clear; many Blacks grew up insensitive to the dimensions and importance of animal care. The unintended consequences are not only that there is less of a premium on animals, but also that many Blacks deem the role of animal caregiver less prestigious than, say, a human physician. So, if given the opportunity to enter one profession versus another, any number of professions may appear more appealing to Blacks than veterinary medicine because a veterinarian’s utility may not be immediately apparent. Thus, obtaining this position may not be perceived to represent the expected rise in status. In this context, racism and classism combine to lead to a certain murkiness when assessing the jobs landscape.

Racism unreasonably interferes with Black people’s access to jobs and their eventual success in those jobs. When racism is viewed in its proper context—a system of advantage that structurally benefits Whites and disadvantages people of color on the basis of group membership—it is not hard to imagine a disproportionality of effects across the business landscape. Bigger, more widely visible and desirable professions are more likely to absorb the effects of disparities, whereas smaller and seemingly less accessible professions have more disparate outcomes when it comes to diversity and inclusion. The relatively low number of veterinary schools makes this profession especially vulnerable to those effects. Cultural differences also play a role in the way jobs in our profession are historically viewed. Finally, lack of representation makes it harder to visualize the goal of becoming a veterinarian, likely leading to Black people favoring other career options; options that may be deemed more likely to raise one’s social status.

Charles D. McMillan, DVM, is a veterinarian with IndeVets and is based in Atlanta, Georgia. He is a 2012 graduate of Tuskegee University School of Veterinary Medicine and has a keen interest in identifying solutions to address racial disparities in the profession.

I was asked recently what I thought contributed to the low numbers of Black professionals in the veterinary field and whether there is something uniquely racist about our profession. Here are my thoughts.

Why so much whiteness in the veterinary profession?

Happy Monday! We have a lot of engaging and informative content coming your way. Here's a quick at some of this week's headlines:

In this engaging Q&A, relief veterinary technician and president of the National Veterinary Professionals Union, Liz Hughston, MEd, RVT, CVT, LVT, VTS (SAIM) (ECC),

 discusses the pros, cons, and future of unions in veterinary medicine

commentary, dvm360®'s chief veterinary officer, Adam Christman, DVM, MBA, encourages veterinary professionals to celebrate Mental Health Awareness Mont

During this week's episode of The Vet Blast Podcast (Sponsored by NEOGEN), market development manager for companion animal health at NEOGEN, Lindsey Kocks, DVM, shares the benefits of genomic sequencing technology for both pet parents and veterinarians. 

Stay tuned on dvm360.com for our most recent coverage of the veterinary industry.

Here is a sneak peek at this week’s headlines.

This week on dvm360: A closer look at veterinary unions, plus more industry news

May was first recognized as Mental Health Month in 1949 by the National Mental Health Association (now called Mental Health America [MHA]). Every May, MHA focuses its efforts on raising awareness about the importance of mental health through education and advocacy.

COVID-19 and our collective mental health

The COVID-19 pandemic has had disastrous effects on mental health on a global scale, a national scale, and within veterinary medicine. More than 500,000 Americans have succumbed to COVID-19, with many pets being shuffled from home to home following the death of their owner. Additionally, many of us know someone who has died from the virus or has recently lost a colleague to suicide. Our profession is battling serious mental health challenges, making collaboration crucial in providing necessary educational tools and resources for those who are suffering.

Part of coping with life’s many challenges is accepting what we cannot change or control. It’s equally important to know how best to adjust to life changes, manage anger and frustration, recognize when trauma is affecting your mental health, challenge negative thinking patterns and, most importantly, make time for self-care.

I recently saw a post on social media in which a veterinary professional talked about the many hours she worked that day with no breaks, no time to eat, and no time for herself. Unfortunately, the post was received as boastful post rather than self-reflective, and that, my friends, is not OK. I know we can do better to support our colleagues. We need to ensure that all of our team members are taking the necessary breaks during every shift to decompress, reset, and recharge.

We work in an often stressful environment, potentially impacting both our physical and mental health. Listening to your body and giving it what it needs—whether that’s meditation, yoga, exercise, watching funny videos, calling a friend, or something else—will help you heal and stay healthy both physically and mentally. Also, make sure you set boundaries with your clients (and your friends turned clients!). I can’t stress this enough. Your time off is your time off!

This past year has taken a toll on all of us. If it has negatively affected your mental health, know that you are not alone. According to MHA, the rate of moderate to severe anxiety peaked in September 2020, with more than 80% of people taking an MHA anxiety screen scoring with moderate to severe symptoms.

Of those who took a depression screen, 80% have scored with symptoms of moderate to severe depression consistently since March 2020.

 for screening and other useful resources. The American Veterinary Medical Association also offers mental health resources. And I am more than happy to chat with any of you! As colleagues, we should stick together through thick and thin. Reach me via email at 

2021 COVID-19 and Mental Health: A growing crisis. Mental Health America. Accessed April 16, 2021. 

It has never been more important to mind our mental health.

May is Mental Health Month: Let the healing begin

Corporation-owned veterinary practices have been around since 1987, when VCA Animal Hospitals acquired its first independently owned companion animal clinic.These giant companies now make up roughly 10% of general veterinary practices and 40% to 50% of referral practices in the United States (numbers vary depending on the source).

The downside to veterinary corporatization? According to Liz Hughston, MEd, RVT, CVT, LVT, VTS (SAIM) (ECC), a relief veterinary technician in San Jose, California, and president of the National Veterinary Professionals Union, it’s nearly impossible to voice your concerns owing to the multiple layers of management. She explained that this is extremely problematic for an industry in which many employees are underpaid and feel undervalued.

The COVID-19 pandemic has taken a huge toll on the veterinary profession. At the start, many practices were forced to close until deemed essential. Some practices struggled to stay afloat financially, leading to a series of layoffs. According to Hughston, that’s where veterinary unions come in. Not only do they help educate employees about their rights, but they advocate for employees who feel they’ve been wrongfully let go or otherwise mistreated.

 sat down with Hughston to talk about the benefits and challenges of unions in the veterinary profession, and why she believes they’re so valuable.

The benefits of unions are threefold: solidarity, accountability, and wage transparency. Unions give you a voice at your workplace. It’s easy for management to discount 1 or 2 people, but when you’re in solidarity with your coworkers, they 

Union members are allowed to have a witness present when discussing matters with management. I think it’s huge to have someone with you to listen and advocate for your rights. So, when a manager calls you in for a performance review, you can have someone there to oversee the conversation to ensure fairness.

Another pro for me is wage transparency, meaning you can go into a practice and see the wage structure. Most veterinary team members are not making a living wage. Most of us have 2 or 3 jobs or rely on a spouse or partner, or live with a bunch of roommates. To me, a living wage means being able to pay your rent or mortgage, purchase food, equipment, or clothes, and still have enough money left over to save or enjoy. Few veterinary staff members can do that with 1 job, and that’s not right. I went to school, I pay a licensing fee for continuing education, and I deserve to be compensated appropriately for that.

Almost every union contract is going to have a “just cause” clause that prevents an employer from firing an employee without a viable reason. In fact, individuals have to go through a process to ensure that the firing is legal and aligns with the National Labor Relations Act. Many people in management see this as a negative because they claim that the union protects unmotivated or lazy employees. I don’t think that’s true. I think the main issue is bad management practices. You don’t have good managers who are putting people on appropriate performance enhancement plans to ensure they’re meeting company expectations. None of us want to work with someone who’s not carrying their weight.

I believe unionization will lead to increased retention and less turnover. Burnt-out veterinary professionals are continually leaving this profession and switching over to human medicine and other careers. If we can pay them appropriately, utilize them better, enhance their benefits, and promote work-life balance, it can change our industry indefinitely.

Unionization is a lengthy process, mainly because we have a very itinerant workplace. People are constantly entering and leaving the profession for various reasons, mainly because of low pay, lack of utilization, etc.

Union members must pay dues. Some people see this as a con, but these dues are more than offset by the benefits unions provide, such as better pay and job protections. Unions aren’t in the business of getting people less money or fewer benefits. Dues are typically set up as a percentage of your annual income that’s withdrawn from your paycheck.

Do you see unions gaining a real foothold in veterinary medicine?

I hope so. There are a lot of challenges and obstacles to unionization. Our itinerant workforce makes it difficult. These are long fights, so you have to find people who are passionate, engaged, and able to stick it out to the end. We’ve received a lot of pushback from corporations, which is not surprising. They wouldn’t be fighting so hard if they didn’t know that it would cost them money.

I am hopeful because there is a lot of interest in unionization in our field. A lot of people are feeling the pressures and are fed up with the lack of control and their voice not being heard and are coming to us for help.

:What role do corporate practices play in the future of unions?

My ultimate goal is to get more practices interested in organizing. That way, corporations like Mars will no longer need to negotiate with individual veterinary practices but instead can sit down with us and create a national contract for all of their practices.

Once we formulate a national contract, if you walk into any BluePearl, VCA, or Banfield facility, you'll know what you'll be paid and what your benefits and rights will be. If we can get to that point, these corporations will be models for how to treat employees in this industry. I think it will raise the bar for private practices because they will have to compete with these union practices.

I would like to see more corporations jump on this opportunity instead of fighting us every chance they get. I prefer to work collaboratively with them to improve the profession. And I think we can do it. These corporations can set the model for how we care for workers, patients, and clients.

Nolen RS. The corporatization of veterinary medicine. American Veterinary Medical Association. November 14, 2018. Accessed April 5, 2021. 

https://www.avma.org/javma-news/2018-12-01/corporatization-veterinary-medicine

National Veterinary Professionals Union President Liz Hughston, MEd, RVT, CVT, LVT, VTS (SAIM) (ECC), answers our questions about veterinary unionization.

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