The Veterinary Flywheel: Balancing Pets, Providers, and Profits

For years, I’ve viewed veterinary medicine through a deceptively simple framework: a flywheel powered by three interconnected forces — pets, providers, and profits. When all three are aligned, the flywheel gains momentum. Healthy businesses invest in teams and technology. Healthy teams deliver better care and improved client experiences. Better care strengthens trust, utilization, and patient outcomes, which in turn sustain the business. The system reinforces itself. But when one part of the flywheel weakens or becomes overemphasized, the entire system begins to wobble.

Over the course of my career, I’ve watched our profession shift from prioritizing the pets portion of the wheel to focusing more heavily on providers and profits. Neither era was entirely right or wrong. Both reflected the realities of their time and involved tradeoffs. Our challenge now: To design a profession where the success of one priority strengthens the others.

The Flywheel of Yesterday

When I was a pup (sometime last century), veterinary medicine largely revolved around the pet. We were open six days a week. We stayed late when cases required it. We took emergency calls at night and on holidays. Vacations were short. Boundaries were blurry. Many of us did whatever we could to get some level of care for every pet that came through the door. Some may remember holding collateral for cash-strapped clients. I accepted jewelry, appliances, and more than a few cords of firewood in exchange for veterinary services. Looking back, it sounds absurd, but at the time it reflected our culture: Take care of the pet first and figure out the rest later.

The result was remarkable access to care. Fees were flexible. Availability was broad. Relationships were deep. For many communities, the veterinarian was equal parts doctor, counselor, business owner, and first responder. The pet side of the flywheel spun exceptionally well.

But that model depended heavily on personal sacrifice. Burnout was normalized. Compensation was often modest. Benefits were limited. Many veterinarians undercharged chronically, delaying investments in equipment, facilities, technology, and their teams. Spouses and families frequently absorbed the burdens of owning a practice. We remember that era fondly because of the relationships, autonomy, and sense of purpose. What we should not romanticize is the model’s sustainability.

The provider side of the flywheel was underpowered, and the business side often struggled to generate the momentum necessary to support long-term growth and reinvestment. At the time, many of us knowingly chose that balance and were satisfied with it. This was the profession immortalized by James Herriot and embraced by generations of veterinarians who viewed service and sacrifice as inseparable.

Fast forward to today, and the flywheel looks very different.

The Flywheel of Today

Today’s veterinarians watched prior generations build extraordinary careers, but often at substantial personal cost. Many decided the profession had to evolve.

Providers today emphasize sustainability, flexibility, compensation, and life outside of work. Three- and four-day workweeks, expanded paid time off, mental health support, scheduling flexibility, and competitive benefits are expected. For too long, vet med accepted that meaningful work required chronic self-sacrifice. Today’s doctors have rejected the false choice between making a living and having a life. And frankly, good for them.

At the same time, the business side of the flywheel has strengthened considerably. Consolidation, business sophistication, analytics, and professional management have increased margins and operational discipline across much of the industry. The reality is simple: Hospitals cannot care for patients if they cannot survive financially. Margin is not the mission, but without margin, the mission eventually collapses.

The upside of shifting focus from pets to providers and profits is clear. Veterinarians today work fewer hours, earn better compensation, and enjoy healthier boundaries than previous generations. Businesses are stronger and more capable of reinvestment. Veterinary medicine has never delivered more advanced medical care.

But every system produces tradeoffs. The downside is that access to care has narrowed. The access crisis isn’t merely about cost, though affordability matters. It’s also about capacity, convenience, geography, workforce shortages, and the growing mismatch between rising pet ownership and the profession’s ability to deliver care within traditional models.

Today, providers are healthier, and businesses are stronger, but tens of millions of pets receive little or no veterinary care. Access is now the defining challenge facing our profession.

Optimizing the Flywheel

Was yesterday’s model better? Is today’s? I would argue neither was fully optimized. One over-relied on personal sacrifice. The other risks limiting access for the very patients we entered the profession to serve. The answer is not to return to the past, nor to double down on the status quo. The answer is redesigning the flywheel itself.

There is no silver bullet. Expanding access will require multiple solutions working together. Some possibilities:

Workforce Multiplication

• Team-based care better utilizing credentialed technicians and veterinary professional associates
• Workflows assisted by artificial intelligence
• Smarter operational design

Expanded Access

• Telemedicine
• Spectrum-of-care approaches
• Mobile medicine
• Community partnerships
• Asynchronous communication tools
• New models of care
• Connected pets

Economic Innovation

• Wellness plans and improved pet insurance offerings
• Charitable partnerships
• Nonprofit models
• Health savings accounts for pet care
• Employer-supported care
• Programs that bridge affordability gaps
• Reduced veterinary education costs

Yesterday’s model of trying to be all things to all people is increasingly difficult to sustain. But abandoning access as someone else’s problem is not an acceptable answer. As a profession, we find ourselves balancing multiple truths. We deserve fair compensation. We need financially healthy businesses. We must protect the well-being of veterinary teams. And we must somehow find ways to care for more pets, not fewer.

None of those goals are mutually exclusive, but achieving all of them will require creativity, openness, and a willingness to rethink long-standing assumptions about how veterinary care is delivered. The future of veterinary medicine will not be built by choosing between pets, providers, and profits. It will be built by designing systems in which the success of one strengthens the others.