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Let's solve the profession's problems one crazy idea at a time
Veterinarians, consultants, academics-it seems like everyone is sitting around practice break rooms, CE conferences and state-of-the-profession summits talking about cures for the veterinary profession. So let's talk big ideas. Crazy ideas. This-would-totally-work-in-a-parallel-universe, best-idea-that-came-out-of-a-hotel-bar ideas.
No. 1 Close some veterinary schools
First up: Decreasing the number of veterinary schools would increase the quality of veterinary students while creating a workforce population that better matches demand.
"Closing veterinary colleges could decrease the number of graduates and make veterinary college acceptance more competitive," says John Volk, senior consultant with Brakke Consulting. "This could reduce the number of veterinarians and theoretically improve quality." He notes that this assumes that the remaining schools (in this parallel universe where veterinary schools could actually be closed, or close themselves down voluntarily) do not increase class size.
"I think the issue is—and this is tough—is fewer veterinarians, not necessarily fewer schools," says Karen Felsted, DVM, CPA, CVPM, MS, president of Felsted Veterinary Consulting.
Volk agrees the more realistic scenario to closing schools is reducing class size. But he says the only way this will happen is if there's an insufficient number of qualified applicants or financial pressures make it untenable to maintain the college. "Due to the increasing class sizes at many colleges of veterinary medicine, and a stagnant applicant pool, the number of applicants per available seats is declining," Volk says, though he also says it's unclear if it has declined to the point that applicants are unqualified. "The law schools are experiencing it now; dental colleges did several decades ago," he says.
However, Eleanor Green, DVM, DACVIM, DABVP, dean of the Texas A&M University College of Veterinary Medicine, said at the Banfield Pet Healthcare Industry Summit in Portland, Ore., last year that veterinary colleges are fed with demand. "How do we look at the masses who want our education and say no?" she asked. Furthermore, she mantains that the quality of applicant is not waning and the applicant pool actually increased nationwide in 2013.
The size of almost every U.S. veterinary school class will increase in coming years, as will tuition, if trends continue. "Many veterinary colleges are struggling financially. Most are in state universities, and public funding in most states has been on the decline for many years," Volk says. "The catch-22 is that it is politically unacceptable to 'give up' the state veterinary school. So the likelihood of closures is minimal."
So, while saying, "Hey, Colorado State, Iowa State, Ohio State—oh, and you too, UC-Davis—cut your numbers or close your doors," seems like a decisive, short-term fix if you believe there is an oversupply of veterinarians, there seems to be no end in sight to the increasing influx of veterinary graduates. The number of graduates for 2017 is poised to jump 18 percent from 2013, so we hope you aren't too attached to this idea. This crazy solution may be just that.
No: 2 Abandon the traditional model
Increasingly, the small practice model (one or two veterinarians) is not financially viable and cannot compete with large practices. The majority of practice owners leave school with little or no business education or experience and a quarter of veterinarians say they know nothing about finances, resulting in a swath of poorly managed practices. This business burden hits vulnerable small practices especially hard.
The shift to larger practices—while still filling the niche market for boutique medicine—would improve the financial, and possibly emotional, health of the profession.
"It's going to happen whether it helps or not," says Michael Paul, DVM, speaker, columnist and principal of Magpie Veterinary Consulting. The general care days are over—practices that only do spay, neuters, vaccinations, heartworm preventive and so on are "on their deathbed," he says. "It would be very, very hard for one doctor or a small practice to provide parallel care that a large practice could. We've gotten too sophisticated."
However, the profession can do little about the individual choices of its less-business-savvy members. "That said, the smart thing to do is for associate veterinarians to seek work in larger practices, and for one- or two-doctor practices to attempt to grow through consolidation," Volk says. "There are many benefits to larger practices, include efficiencies in capital expenditures, flexibilities in work schedules and more 'brains' to contribute ideas to help the practice grow."
Felsted says it may not be the small practice model itself but the individual owner who makes or breaks the business. She says a small practice can sometimes provide personalized services and long-term relationships that large practices can't match. "What it comes down to is the talents and the interest of the individual owners and their ability to find a niche that works," she says.
And Paul adds that there's always a niche market for boutique care. "If I were a single veterinarian, I'd say, 'You can call me 24-7,'" he says. But, he warns, "veterinarians have made such big investments, they're not willing to rethink them."
Those practice owners who report that they're doing poorly financially and who run a traditional small practice might think of reinventing themselves into a concierge veterinary service, consolidating with another clinic—or closing up shop and going to work for veterinarians who are financially successful.
However, Paul says those owners may be the veterinarians that make up the bottom of ownership's bell-shaped curve. "The bottom 20 percent probably won't be here in five years, maybe not even two," he says. "Some veterinarians, you never see them at meetings; you never see them at CE. If they sold their practices, the world wouldn't miss them at all." And he's not sure anyone would hire them either.
Paul agrees with Felsted that it's the specific veterinarian who makes an impact: "A lot of it is the individual and their talents and skills and their willingness to focus on the business aspect," he says. So this "crazy solution" may begin with veterinarians becoming more willing to educate themselves about business.
Here's a shameless plug: If you're among the 41 percent of veterinarians who are overwhelmed by finances or the 25 percent who say they know nothing about financial matters, the CVC in Washington, D.C., begins May 8—with practice management sessions galore.
No. 3 Go where the work is
Veterinary school graduates should be willing to accept a position wherever it's available. There may not be a job in a suburban hometown, but if there' work in Arkansas or Montana or some other area, that's where a newly minted veterinarian needs to be prepared to go. A better distribution of veterinarians would provide better access to veterinary health and reduce the pressure on excess-capacity flooded markets.
"I don't think anyone's ever going to a get a perfect job—the job you want with the pay you want where you want," Felsted says. It comes down to priorities. If it's your top priority to stay in a certain geographical area, you may have to settle for a job that isn't perfect—or even unemployment.
Paul says he's not sure all graduates are interested in making the sacrifice of moving. "They need to be willing to sacrifice. Yes, they've sacrificed the last five years, 10 years even, but they're going to have to sacrifice more," he says. "The first job—even the second job—they're going to take is a learning experience. It's not bloody likely that they're going to stay in that practice for 40 years."
You never know, associates, it might be crazy to move to Arkansas. And practice owners, if you make it worth a new grad's time in terms of salary and benefits, you could make it the best decision they ever made.
No. 4 Radically alter veterinary education
Reducing the years of pre-veterinary study and streamlining veterinary school curriculum will reduce student loan debt and better prepare graduates for their chosen veterinary path.
"Forty years ago the standard education was two years of pre-vet and four years of vet school," Volk says.
Yet there seems to be a consensus that the model for veterinary education needs to change. "I don't see any reason to have four years of pre-vet," Paul says. "I think back to my pre-vet days, and there were maybe two or three classes of value in terms of my veterinary education. A little bit of chemistry; a little bit of physics. But calculus? For God's sake, who needs calculus?"
Felsted agrees that from a practical standpoint, communication, business, accounting and life-skill classes would benefit today's veterinary students more than, say, classes that merely acknowledge that a student has the intellectual wherewithal to pass them. "In my mind, that's a very easy change," she says.
Paul says veterinary curriculum should also be scrutinized, and he's not alone. "There should be two years of basic medicine followed by two or three years of clinical medicine in a designated species field such as companion animal, bovine, swine or equine," Volk says.
He says basic medicine should be available at every veterinary college, but colleges should develop a system to offer clinical education in various fields based on opportunities in that field. "There's probably a need for only two or three swine programs, but perhaps 15 or so companion animal programs," Volks says.
"We're trying to do too much," Paul says of the current educational model.
However, Paul, Felsted and Volk—and the data, for that matter—all point to one subject where pre-vet and veterinary curricula are lacking: business. "Every veterinary school should require a minimum of three business courses, one of which is accounting, for acceptance into veterinary school," Volk says. "And every veterinary school should offer a full year of required practice management education, ideally during the clinical years."
So here's a thought for veterinary students or those aspiring to be veterinary students (since the politics and policies of academia are often slow to change): take business classes. Even if you don't plan to own, even if you think the subject will bore you to tears. Nearly all of you will have to manage significant financial debt when you graduate, all of you will need to save for retirement, and many of you (possibly through said business classes) will find out that ownership may be the quickest way out of debt. Well—that, or marry rich.