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Change maker series: Shawn McVey

Article

Experience running large referral practices, and a background in social work give this leader insights into the changes specialty care brings.

Editors' Note: This is the second in a series of articles about change-makers—the thought-leaders who've profoundly affected the business of veterinary practice and whose vision could change practitioners' career path, business model, or workday in the future.

LAST NIGHT SHAWN MCVEY WAS COMMUNING WITH veterinary students in Pennsylvania. This morning he hustled his luggage out of the Phoenix airport for a quick sprint home. Now, after a frantic turnaround, he sits at a big wooden table in La Grande Orange restaurant in an ice-blue shirt and blue-black tie thinking about how a guy with degrees in political social work and marriage and family therapy ended up so deeply involved in veterinary medicine.

The path that took McVey from a private counseling practice to managing specialty veterinary hospitals is not a straight one. He lays the blame at the feet of a leotard-clad woman who approached him 10 years ago—a woman who turned out to be a dermatologist at the Veterinary Referral Center of Colorado. This woman saw something in McVey that would enable him to become a leader of veterinary specialists.

And lead he did. The Veterinary Referral Center of Colorado flourished. McVey moved on to Eye Care for Animals in Phoenix in 2002 and impressive growth ensued there as well. He began to garner a reputation for his work in the emerging specialty practice movement—which in many ways is redefining the organization of veterinary medicine—and for his ability to take listeners inside the emotional content of team building and leadership.

As the only nonveterinarian in 75 years to sit on the board of the American Animal Hospital Association, Shawn G. McVey, MA, MSW, brings an outsider's sharp eye, a student's curiosity, and a counselor's empathy to the dynamics of management in modern veterinary practice. Veterinary Economics asked McVey—who is CEO of his own consulting firm, Innovative Veterinary Management Solutions—to take us back a decade to the pioneer days of the specialty referral movement and his inauguration into the profession.

Q. Tell us about your background in marriage and family therapy and social work.

A. After I finished my first master's degree in the late 1980s, I started a private marriage and family therapy practice in Houston. My clients were primarily families dealing with gay and lesbian issues, and I had a good ride for about two years. But then HMOs and PPOs came on the scene and decimated my business. Clients couldn't afford to pay $100 an hour out of pocket, and I needed to eat. I also discovered that social work was a much more useful degree if you wanted an eclectic job opportunity, so I got a degree in political social work.

What's that?

Political social work is about social systems and how macrosystems interact. If you want to run a political campaign, you have to understand large groups—Republicans and Democrats and religious fundamentalists and atheists and how they all interact. It was a fascinating degree.

But it's not like accounting. You don't walk out and get a specific type of job.

No, but I knew enough to follow what I was interested in. I never intended to be in veterinary medicine. I thought I would be a social worker at a nonprofit organization. My goal was to be altruistic and help people. To make a really long story short, I had a relationship end badly, so I did what therapists call a "geographic cure." I put a finger on the map, and Denver, Colorado, popped up. I took a job with an insurance company where I talked with people on the phone and either allowed or disallowed their claims.

That sounds dreadful.

It was horrible. I thought, "I did not go to school to ruin people's lives." So I put a prayer out to the universe saying I wanted a job with some altruism attached to it. I quit my job and got by with teaching fitness classes. I had a noon class on a Tuesday, and I came in after drafting a letter to my mother (which I never sent) asking to borrow money from her. I was angry and frustrated, and I said to the class, "I'm going to make you work." Afterward a woman came up to me who I just knew as "Linda in the leotards." It turns out she was a dermatologist at the Veterinary Referral Center of Colorado. She asked if I had ever thought about running a veterinary hospital. I said, "I didn't even know there was a job like that."

So that's how it started?

I took the job at VRCC in Denver. That was 1997. The business was doing $3.5 million a year, and under my tenure it was up to $15 million a year and in a new building with 23 doctors. I did things that now seem de jure: offered tours of the facility and told clients how much the light fixtures cost. Told clients that the average veterinarian comes out of school with X amount of dollars in debt. Allowed clients to sit and view surgeries. Gave clients copies of ultrasounds and whatever else we could videotape. Went to general practitioners and asked them to give us a report on the service they were receiving. These were all strategies I learned as a social worker.

And what were the results?

Clients noticed—at least they told me they noticed—a distinct increase in the level of customer service. They wondered how all those disparate egos could possibly get along. And, really, all that we did was meet on a regular basis. We communicated. We put issues out there. I didn't let doctors or team members get away with avoiding conflict. That's how I was trained. That's what social workers do.

Honestly, you could knock me over with a feather today. I'm completely surprised at what has happened in my life. I would have never guessed I'd be here today.

How did you get involved with AAHA?

Fortuitously, AAHA is located in Denver. They heard what I was doing at VRCC and asked me to speak at their annual conference. That started a whole new public speaking track for me. What AAHA didn't know was that I worked my way through undergraduate school as the lead singer in a country western and gospel band. In graduate school I was a flight attendant. I have a lot of experience being in front of people. I love to perform. The timing was right.

Was there anything else in your background that prepared you for veterinary medicine?

I was a psychiatric technician in my first job out of college. I saw people eat cigarette butts because they were so crazy. I had to tackle people. It was a hard job. I got paid very little and I faced enormous challenges dealing with doctors and clients. I did what veterinary technicians do with sick animals, but I worked with sick people.

It seems like you got to Denver at exactly the right time for specialty practices.

Yes, it was the right place and the right time and the right group of people. Denver is the pet-friendliest city in America. It's the market that proved to specialists that if you build it, they will come. Clients want what we have. Animal Planet marketed specialty medicine to the Denver public by showing Alameda East, Dr. Robert Taylor and Dr. Kevin Fitzgerald, and that whole emergency vet thing. People started pouring in the doors of specialty hospitals.

So what was your role in this specialty growth?

I taught my doctors not to worry about aggravating a veterinarian who didn't want to refer. It wouldn't hurt them if I went to that veterinarian and flat-out asked, "Why don't you refer to us?" They would look at me like, "Who are you?" and "That's a bold question." I could get away with that, I think, partly because I'm a social worker and I knew if I was getting close to offending them, and also because I wasn't the specialist. I could say, "I'm sorry. I just didn't understand the dynamics." I could plead ignorance if I needed to. And they would open up to me. I wasn't the specialist, so they weren't intimidated.

Did they then start referring patients to you?

Well, I would say things like, "I see that you have that mission statement on the wall that says you practice excellent medicine using state-of-the-art techniques and you care the utmost for your clients and your patients. So help me understand, because I need to talk to our dermatologist about why she hasn't seen a referral from you in five years. I'm assuming it's because you've had no dermatology cases?" The next day there would be a case.

Really?

The next day. They just didn't trust. They needed to know that we would give the case back. Generalists are often afraid that they'll be cut out of the loop, so I would look them in the face and say, "I promise you we will keep you in the loop. If I don't keep that promise you can have my ass on a platter."

Tell us about VSIPP, the Veterinary Specialists in Private Practice symposium.

I believe that specialists need the opportunity to get together once a year so they can network, talk about business, and let their guard down. We put them by the pool, give them a drink, and let them talk to the person next to them and say, "You have a $5 million business and you don't have a budget either? I guess I'm not so stupid." Doctors are trained to always have the answers. Their egos—and I mean this in a positive way—their egos will not allow them to not know the answer. I want VSIPP to be a place where it's safe not to know the answers. I'm amazed at how the conference has grown. This last year we had 267 attendees, up from 57 three years ago. It's very exciting. I expect we'll have 400 or 500 attendees next year.

How have you been involved with students?

The last year and a half I've been visiting every veterinary college in North America on behalf of the Veterinary Business Management Association. I speak about emotional intelligence—how students can be psychologically prepared for workplace culture. It's a new day for veterinary students. It's a different environment than what their mentors came up in.

For one thing, the schools are not just picking the 4.25 GPAs. Candidates who interview with a 4.0 or above are often robotic and monosyllabic in their answers, and they're not being chosen over people who are extroverted, show some chutzpah, have dual goals in life, and can talk about family and spirituality and giving back to the community.

What do you think of the growth of the number of women in the profession?

As much as we want to say that a new generation of men are helping out at home, the truth is that when two professionals are in the household, women still do 75 percent of the work and 75 percent of the nurturing. If you make a woman choose between child and work, she will usually choose the child. Men have never had to make that choice unless they're widowers or divorcees.

At Eye Care for Animals we've gone from a predominantly male-doctor culture to a predominantly female-doctor culture. It's a significant challenge. These doctors are just not as available to do what the original doctors did, which was work 80 hours a week and produce an outrageous volume of revenue. Now doctors are saying, "Hell, no. I have to live and I want a life." The great news is that, despite that, we recently had the best month in the history of Eye Care for Animals.

When did you transition to Eye Care for Animals?

That happened in 2002. Eye Care for Animals was experiencing typical growing pains, and the culture was falling apart. Founder Reuben Merideth called me and said, "Do you work with people who cry?" Like, are you good at that kind of thing. He was joking—but not really, now that I know Reuben. He had a lot of crying employees who wanted his time and attention. He said, "I want somebody who does all that touchy-feely management stuff." I said, "OK," and that's how it started. A week and a half later I was moving to Phoenix. That was five-and-a-half years ago, and since then we've gone from six-and-a-half locations to more than 20 locations—24 if you count our satellites.

What is your role there now? And will it be changing?

My contract with Eye Care for Animals was up this year. Because I've been an integral part of the culture there, we didn't want to sever me from the group in a way that the employees would think anything was wrong. There is no rift.

I will be doing more of my own consulting and speaking with my management company. I can always go back—I think that Eye Care for Animals will always make a home for me if I want that. It gives me confidence to try my own thing.

What will veterinary practice look like in five or 10 years? Will it be radically different?

Radical is a strong word, but there has been a radical shift even in the last five years. We're moving from a culture of being medicine- and owner-personality-driven to being employee- and client-needs-driven. The culture will be much more collaborative. Successful practices will be those where everybody talks and everybody tells their truth. We'll move away from a secretive culture toward one that's open.

We've talked in the profession for a long time about needing a higher-caliber employee, an employee who can think for himself or herself, who doesn't have to figure out basic customer service. With that employee come questions. Employees who think for themselves want to know why they have to do things and not just what they have to do. They can work for a dollar anywhere.

I hope that if I have a legacy in veterinary medicine, it's helping to create a career path for nonveterinarians. It's always been a profession for veterinarians, but now the whole clinic is becoming a profession. Being a team member is more than a dead-end job. You can grow in your job as a veterinary technician to be anything. You can grow from a veterinary receptionist into an integral team leader. So that's another cultural shift.

Anything else changing?

Another radically different piece of the culture is the influence of women. Women insist on a more nurturing environment—and I can get away with saying this because I'm a gay man. That has been, by the way, a huge blessing when I've worked with groups of people. I can say things that straight men can't say because of the tensions and political realities between men and women. I can confront all of the taboos. I can say to a woman during a private conversation, "Let's talk about the sexes and dynamics here."

That's interesting.

I can also talk to heterosexual males, macho guys. I'm not too offensive to them because I'm tall and athletic. They're like, "Well, he's a little light in his loafers but he can still probably kick my ass." So I can say to them, "I know you're thinking this way but it's not right. Let's go a different way." They'll listen because I'm male, but they also think, well, he's got some insight into what's going on with the girls. I've found it to be extremely valuable. Political social work. That's what it is.

What kind of influence will specialty care have?

I think we're going to see a lot more market segmentation in general. We'll see more cats-only clinics, practices that focus on boarding and puppy classes, and community-education environments. Other types of practices will provide high-end specialty medicine like the Mayo Clinic. I think market segmentation will be the next wave of what happens in veterinary medicine.

Shawn McVey will be speaking at CVC Central about client service and handling the doctor who doesn't play well with others. For more, visit theCVC.com.

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