“GOOD VETERINARY MEDICINE IS NOT CHEAP, AND CHEAP VETERINARY MEDICINE IS NOT GOOD”
Anytime, anywhere, if we are given the same dollars for equipment, supplies, etc. I will put my profession up against the human side, and win, any day.
Mark my words. We are the best trained, the most compassionate, and the least paid profession in town. We are the “best deal” around!
I am saddened by what I see us doing to each other. Rarely are we colleagues, but more times than not we find ourselves competitors. Why, Why, Why!!! Oh, we go to our local meetings, and “put on a happy face”, but we go right back into our own environment and compete, compete, compete, and we do it for less, and less, and less. Will we never learn? I think POGO was right when he said, “I have met the enemy and it is me”.
My name is Jim Wilson, and I graduated from veterinary school in 1970. I have been involved with this profession, in one form or another, since 1961. I have done both large and small animal medicine, and I owned my own practice for 27 years. I have also worked for others. For the last 18 months I have had the pleasure of meeting some of you as a relief veterinarian. I am also an independent contractor for a veterinary software company and I do practice consulting and assessments.
I know all of you very well because I am you. Regardless of your particular situation, or whether you practice large or small animal medicine, I have been you. I know your concerns, your mood swings, your independence, your mindset, because I was you. However, we can all change and change is definitely what this profession needs.
When I drive into a town to do relief work I always look at three criteria that impact all of us on a daily basis. I do not look at the cost of homes or land. I look at the cost of a gallon of gas, the cost of a gallon of milk, and the cost to go out to a restaurant. That is pretty simple. As of the middle of August 1999, gas varies from $1.10 to $1.59 in any place I drive through or work. A gallon of milk is $2.00-$3.00, and it costs the same to eat at the Golden Corral in one town as in another. Yet, I find in that same place that the basic office visit will vary from $15.00 to $29.00. Does the owner of the clinic charging $15.00 get a deal at the gas station, or is their milk cheaper, or does the owner of the restaurant give them a dinner at half cost? I think not!
This saddens me. I was recently in a town doing relief work. I went to lunch with one of my classmates and he divulged to me that he had not raised his fees in fifteen years. All of the clinics in town charge the same low fees. Why? Why can’t we hire the kind of people we need to run our practice? For years I have said that veterinarians need $12-15.00/hour people, and we pay $6-8.00/hour and wonder why we have problems with staff turnover. New graduates have a debt load far greater than I even knew existed from school expense, and we cannot afford to pay them more than $38,000-$40,000. We live in the best economy this country has ever seen, and now, for once in our professional lives, we have access to some wonderful technology, but many cannot participate because of their mindset that their clients won’t pay for it. WRONG!, WRONG!, WRONG!
I have worked in practices that need to be bulldozed and rebuilt. I have worked in some that are very modern and upscale. Every one of them has a substantial number of A & B clients who will pay for services rendered. I have yet to work in any practice where the fees were too high. I have worked in a lot of practices where the fees are too low, the veterinarian wonders why help is so hard to find, why there is no associate to hire, or why they cannot afford a relief veterinarian once a week.
I am 60 years old. I spent 6 years in the U.S. Navy from 1957-63
before going to college. I graduated in 1970 from Texas A & M,
CVM. I am telling you this to let you know that at my age veterinary
medicine is still exciting. I cannot buy the excuse “well, I’m too
old to learn the new computers, ultrasound, etc”. That is nothing
more than “burn out”, “fear”, or “laziness”. I like all of the “new
toys”, but do not know how to use all of them. This is still an exciting
profession, but it needs an overhaul of attitudes. In my opinion,
for whatever it is worth, either change with the times and technology or
sell and get out. Make room for the next generation. HOWEVER,
DON’T SELL TO A CORPORATION. (more later)
In the next 5-10 years we will likely lose the vaccine market, and
the prescription market unless something changes. Hey folks, that
might be the best thing that happens to veterinary medicine. Well,
what will we do then? What were we trained to do? Give shots,
send home scripts? NO, NO, NO, we were trained to practice medicine.
Practicing medicine cannot be done through mail order or on a parking lot
during a shot clinic. When you were in school how much time did you
spend just giving vaccinations, or sending home scripts? How much
classroom time was spent doing this activity?
It is time that we lower all vaccine fees down to a level where they should be, and we charge for our time. An example might be that a combo of vaccines would include Rabies, DHPPC/K.C. for $15.00, but our office visit would be $40.00. That is right, $40.00. Have any of you who read this ever referred a patient to a specialist? Do you know what they charge for an office visit? Prior to sending the patient, did you do any work-up on any case referred? Doesn’t it stand to reason that since you are referring to a specialist, and since you have already done some of the work for that specialist, and since you have the knowledge when you need to consult or refer for special procedures and opinions; that your office visit fee should be at least half of what the specialist charges?
After having been in your practices for the past 19 months I believe that every clinic’s minimum office visit fee should be $30.00 to $40.00. I don’t care what your facility is like and I don’t buy the excuse that “my clients won’t pay”. As I said before, every practice I have worked in has loyal A & B clients. If you do not have the numbers, maybe it is time to merge with another clinic or move to a better location.
IT IS TIME FOR VETERINARY MEDICINE TO STOP CRYING about what so-and-so is doing and start working together as colleagues. There are too many individual clinics in some locations with too much duplication. It is time to consolidate, work together, and obtain the best equipment for all to use. Hey, we might be able to take some time off too. “But what about my building”? Some of them need to be bulldozed, so do it and sell the land.
IT IS TIME THAT THE COLLEGES OF VETERINARY MEDICINE START HAVING CLASSROOM TIME ON PRACTICE MANAGEMENT, AND HOW TO WORK TOGETHER. They are training doctors who are financially broke when they graduate, and the profession does not help the situation by having low fees. Veterinary salaries are the lowest for new graduates behind physicians, attorneys, dentists, and chiropractors. We, however, in my opinion, are THE BEST TRAINED.
Ladies and Gentlemen: As much as I love this profession, as hard as I have worked to encourage you to change, as many different clinic I have visited and worked in to make my own assessment about the state of my profession, I am convinced that Pogo was right. “I have met the enemy and it is us”. It is not going to get fixed by wishing it so, or by lowering your fees to take business from one of your “colleagues”, but rather it will only be healed by cooperation between colleagues, in some cases consolidation of facilities, and a fair fee structure across the board. I used the office visit as an example, but most places that I have visited need the fees re-evaluated across the board. Since Pogo discovered that “we are the enemy”, then it should not be too hard to reverse the tide of the war. It will require a mind-set change in each of us though.
Finally, I mentioned corporate medicine earlier. I do not believe that they are the answer, but may be more of a problem. I sold to a corporate group, and regret it still. It is water under the bridge, and if you talked with them they would tell you their side. Just remember, up front they are going to take 20% off the top to run the corporation, which includes benefit packages, etc. I believe you can do pretty well on your own by following some of the solutions we have discussed here, and hiring a good, qualified office manager. You will need to pay that individual a fair salary, and to do that you must change the way you are doing things today. The horror stories about corporate buy-outs are just beginning to surface. Let us hope it is not another RECOMM. Just remember Pogo.
Jim Wilson, DVM
1412 Southern Plantation
College Station, Texas 77845
409-690-8115
409-690-9219 (Fax)
[email protected]
FYI: I have a nephew who graduated from Texas A&M University with a BS degree in Industrial Distribution. His starting salary was higher than that of Doctors of Veterinary Medicine who graduated in 1999. His benefit package was great too. By the way he graduated in 1990.
Dr. Jim Wilson and his wife, Carol, sold his practice 2 years ago, and
moved to College Station to be with their grandchildren. He does
statewide relief work for small animal practitioners, he is an independent
software contractor for a veterinary software company, he helps veterinarians
find and obtain newer and better equipment to upgrade their clinics, and
he does Practice Consultations and Assessments for practitioners anywhere
in the Nation.