The changing mixed veterinary practice business landscape
The future of mixed-animal practice will survive if practice owners are willing to compromise with associates.
There are plenty of successful mixed-animal practices across the country and new graduates are still signing on at these practices as associates-but there's been a shift. Recent graduates' priorities are changing and so is the medical focus within the first two years of practice. Will these changes doom the future of mixed-animal practice?
The slow evolution of grads' priorities has impacted the process of hiring a new graduate. Years ago, associates were mostly male, they wanted to become a partner at the earliest opportunity, and they expected to pay their dues as newbie associates. This is no longer true. Today, most grads are women, neither gender seems as concerned with practice partnership, and a consistent approach to employment terms centers around the benefits available now rather than later. In an industry known for sending graduates into practice with the heavy weight of student debt, associates have always been concerned with what they will earn. Several years ago, that may have been the principal concern, along with how they might fit into a practice. Today, while salary remains a top priority, there are other concerns-some that make mixed practice less attractive.
Flex time and commitment to family
A concern among new veterinarians is the balance between home and work. The older generation of veterinarians-especially equine doctors-expected to go home after the work was finished. Period. There were fewer multi-doctor practices, and veterinarians enjoyed an extremely personal relationship with their clients-some practiced out of their homes. While veterinarians of today's generation also pride themselves on their relationship with clients, there's more separation and different expectations for their time away from work. Some might point to the changing gender demographic among graduates to find an explanation for doctors who are more concerned with family time, but many men are just as likely as women to prioritize their time at home.
New veterinarians are looking for employment at a practice that will allow unscripted changes in schedule, the flexibility to leave early or come in late if family needs arise, and the opportunity to work fewer hours in the week. Unfortunately, most young associates don't equate fewer work hours with less pay. Dr. Don Howard of Twin Oaks Veterinary Hospital in Salem, Ore., says new associates want more benefits, fewer hours of work per week, and an increase in pay to compensate for the time not working. While many practice owners are adapting their job offers to graduates accordingly, the fewer work hours can lead to other challenges in practice.
Dr. Howard says that becoming a better-than-average veterinarian is tied to caseload and the intensive learning curve typical of an associate's first few years. “Slowing that natural development makes it difficult to achieve success, earn respect from clients and peers, and to sharpen the ability to practice quality medicine,” Dr. Howard says. While an associate will still get to the level of practice that is expected, it may take longer, which becomes a financial consideration when negotiating a contract.
Emergencies: Take 'em or leave 'em
Many mixed practices, because of their commitment to equine clients, provide emergency services, both for horses and for small animals. While many cities offer viable alternatives for after-hours companion animal care, the same can't be said for horses. Further, due to the nature of equine veterinary care and the typical relationship between client and veterinarian, it just isn't as practical for some. The issue of after-hours emergency work is one of the most critical when deciding on the terms of employment, and one of the biggest threats to mixed practice.
Graduate veterinarians who are focused on equine work will usually handle the emergency load without complaint. Most are prepared to work in an ambulatory setting—possibly even on their own someday—and they understand the necessity of providing after-hours care. New associates who are split between companion animal and equine practice, or those focused primarily on dogs and cats but hired by a mixed practice, are more likely to consider emergency work an obstacle. At Silver Creek Animal Clinic in Silverton, Ore., three associates hired in the past six years left the practice primarily due to the demands of emergency work. In all three cases, they were aware of the expectations outlined in their contracts, but they decided that giving up their time outside of the regular workday wasn't justifiable. All three relocated to companion animal practices that refer emergencies. For associate veterinarians not absolutely committed to equine practice, this issue can become the catalyst for career decisions and as a result, poses a threat to the future of mixed practice.
Maintaining your chosen practice focus
In addition to other challenges, no veterinarian wants to be dissatisfied with his or her preferred area of practice. The true mixed practitioner may be out there in numbers, but in this economy, a new mixed-animal veterinarian is more likely described in one of two ways: an equine practitioner who's willing to compromise and accept working on companion animals as well, or vise versa. Neither are good long-term prospects for a practice.
Dr. Howard says it's more difficult than ever to find quality associates for mixed practice. One reason, he says, is that there is so much more known about each species than 20 years ago, making mixed practice more daunting to a new graduate. In Dr. Howard's experience, most practitioners are looking for equine or companion animal practice rather than a mixed animal position. He also noted that if one group was willing to compromise, it tends to be an equine practitioner willing to join a mixed practice instead of the other way around. The reasons for that can be twofold: People who are not horse-savvy-including veterinarians-may be intimidated by the size and physical danger of the horse, and in this economy, equine practitioners have been hit especially hard, driving many to expand their focus.
At Silver Creek Animal Clinic, in addition to the three associates who left because of emergency work, at least one other doctor left in an effort to find a heavier load of equine casework. The practice's two most recent recruiting cycles turned up nearly 50 resumes each time, but very few mixed practitioners. Attempts to pose these questions directly to prospective graduates met with some resistance. Two veterinary schools did not return email requests to interview their students, while a third school politely declined. Direct contact with one graduate and two associates who graduated in 2011 resulted in the same feedback. All three declined to be quoted on the record for the same reason: concern that a public statement about their preferred area of practice might limit their ability to be offered a job in a different area.
Mixed practice will survive-if only because they're necessary in some areas, still profitable, and in many cases, still a preference for the veterinarian. However, employers will need to be ready to compromise in a number of areas if they wish to hire and retain quality associates. Creating flex time options for associates, reducing emergencies with the creation of a regional call group, and allowing Dr. Jones to come in late so he can see his daughter's play at school are areas in which practice owners should be willing to concede some ground.
Kyle Palmer, CVT, is practice manager at the mixed animal practice Silverton Animal Clinic in Silverton, Ore.