Veterinarians have been debating compensation models for years, but recently the conversation around ProSal has gotten louder. In a recent Today’s Veterinary Business column, Dr. Stacee Santi raised thoughtful concerns about ProSal. Her reflections touched on the tension between practicing great medicine and feeling like every decision carries financial weight.
If you’ve ever caught yourself mentally calculating production during an appointment, you know exactly what Dr. Santi is talking about. And honestly? I get it. I was paid on production as a technician, and part of me liked it. Growing up a competitive tomboy with three sports-obsessed brothers, I thrive in environments that push me to work harder, think more critically, and look at the whole patient, not just the presenting problem.
Veterinary medicine is one of the only professions where we expect people to be deeply compassionate caregivers and quietly brilliant business operators, often without teaching them how to do the second part.
Dr. Santi isn’t wrong to raise the concern. Her article highlights several issues our profession should take seriously. But I don’t think ProSal itself is the villain in this story. The real issue is simpler and harder at the same time: Our compensation systems often reward the wrong things.
Compensation systems don’t just pay people. They teach people what matters.
Here’s the uncomfortable truth: Most veterinarians don’t hate production pay. They hate feeling like production is the only thing anyone notices. Recognition matters. Mentoring, collaboration, emotional labor, and the quiet leadership that keeps hospitals running deserve to be noticed, too.
The Balancing Act of Veterinary Medicine
Veterinary medicine lives at an uncomfortable intersection. We are caregivers. We are scientists. And, whether we like it or not, we are business operators. Sometimes those identities pull against each other. Compensation models like ProSal were originally designed to balance two competing realities: Veterinarians deserve financial stability, and veterinary hospitals need revenue to survive. On paper, that balance makes sense.
Where things start to wobble is when production becomes the only metric that matters. When a system rewards only one behavior, it quietly teaches people that everything else is secondary.
That lesson might not be intentional. But it is powerful.
The Work Production Reports Don’t Capture
Every hospital has that doctor. The one who stays late to help a technician master anesthesia monitoring. The one who sits with a grieving client after a euthanasia because the client just can’t leave yet. The one who mentors new graduates through the moments when imposter syndrome hits hardest.
Those contributions rarely show up on a production report, yet they are the backbone of strong hospitals. They build trust with clients. They strengthen teams. They create cultures where people want to stay. If our compensation systems ignore those contributions, we shouldn’t be surprised when doctors begin to feel like production is the only thing leadership truly values. Not because anyone said it. Because the system did.
When ProSal Works
ProSal exists for good reasons. When structured thoughtfully, it can offer veterinarians:
- Stability: A base salary protects doctors from the normal fluctuations of hospital caseload and provides financial predictability.
- Recognition: Production rewards doctors who contribute to the financial health and growth of
the practice. - Shared success: When the hospital performs well, the people creating that success benefit too.
In theory, this balance allows veterinarians to focus on practicing good medicine while also recognizing the financial realities of running a hospital. But when transparency disappears, credit sharing becomes murky, or expectations become unrealistic, the system begins to feel less like recognition and more like pressure. And pressure rarely produces the culture we hope to build.
A Better Question
Perhaps the real question isn’t whether ProSal works; it’s this: What behaviors should veterinary compensation reward? Because the list includes more than revenue. Great hospitals are built by doctors who:
- Mentor and collaborate across the entire team.
- Communicate clearly with clients.
- Practice thoughtful, spectrum-of-care medicine.
- Support their teams during difficult cases.
- Build trust within their local communities.
Production is only one piece of that equation. The more intentional we become about compensation design, the more opportunities we have to reinforce the behaviors that make veterinary medicine sustainable for people and businesses.
Culture Will Always Beat the Spreadsheet
One of the most fascinating things about compensation systems is how differently they function depending on the culture surrounding them. I’ve seen this play out firsthand. I’ve worked in two hospitals using almost identical ProSal structures. Same percentage. Same base salary philosophy. Same production calculations. On paper, the systems were nearly clones.
In one hospital, the doctors collaborated constantly. Cases were shared freely. When something complicated walked in the door, the conversation sounded like, “Hey, can you take a look at this with me?” Production existed in the system, but it didn’t dominate the culture. In the other hospital, the same compensation structure produced something very different. Doctors guarded appointments. Collaboration dropped. Production became the quiet scoreboard running in everyone’s heads.
The formula didn’t change. The leadership did.
Compensation systems don’t exist in a vacuum. They operate inside cultures shaped by transparency, expectations, and trust. When leaders are open about finances, fair about credit sharing, and clear about what behaviors matter, production-based systems can function as one piece of a healthy structure. Without those things, even the best-designed compensation model will struggle. Because culture will always shape how the spreadsheet is experienced by the people living inside it.
The Goal Isn’t More Production
The goal of compensation shouldn’t be maximizing production. The goal should be building sustainable hospitals where veterinary teams can thrive and:
- Doctors feel valued.
- Technicians and support staff feel supported.
- Clients experience trust.
- Leadership can afford the staff, equipment, and training necessary to practice excellent medicine.
In those environments, financial health supports clinical excellence rather than competing with it. If ProSal is designed thoughtfully, it can absolutely be part of that ecosystem. But the model alone won’t get us there. That work belongs to leadership.
The Opportunity in This Conversation
The renewed debate around compensation is a healthy one for veterinary medicine. It’s forcing us to look closely at the systems we’ve inherited and ask whether they still serve the profession we want to build. Dr. Santi’s perspective adds an important voice to that conversation. Perhaps the takeaway isn’t that ProSal should disappear. Perhaps the takeaway is that our compensation systems deserve the same level of thoughtful design we expect in every other part of veterinary medicine.
When incentives align with the values we say we hold as a profession, something powerful happens. The business works. The teams stay. The medicine gets better. And that’s a future worth building for the people, practices, and patients who depend on us as leaders.