Discharge Notes columnist Dr. Andy Roark is a practicing veterinarian, international speaker and author. He founded the Uncharted Veterinary Conference. His Facebook page, podcast, website and YouTube show reach millions of people every month. Dr. Roark is a three-time winner of the NAVC Practice Management Speaker of the Year Award. Learn more at drandyroark.comRead Articles Written by Andy Roark
I was standing in the massive exhibit hall at VMX 2023 when it hit me. Where pet food and pharma companies used to dominate the exhibitor landscape, now I saw corporate veterinary practices, telehealth providers and a particular online retailer of pet products that’s known for amazing customer service. That’s when I realized this: Our industry is changing, and it’s never going back.
I Was Right. But Mostly Not.
In 2009, back when VMX was called the North American Veterinary Conference, I had breakfast in Orlando with two friends from veterinary school. We sat together, and they told me about a fantastic idea. They explained that they were starting a business where veterinarians would refer clients wanting house calls (specifically end-of-life care) to the two of them, and they would provide those services. The idea was that pet owners wanted house calls but that veterinarians in brick-and-mortar practices were too busy to travel. Thus, referral!
I listened politely and then told my two friends their idea would never work. I explained that veterinarians wanted to keep things as they were and not share such clients. “Those end-of-life visits are so important for relationships that I don’t think veterinarians will give them up,” I said.
You know what? I was totally right about veterinarians not wanting to give up those appointments. And I was totally wrong about the business idea not working.
My friends were Drs. Dani McVety and Mary Gardner, who went on to found Lap of Love, the largest hospice and end-of-life provider in the United States (and almost certainly the world), with over 300 veterinarians and 150 care coordinators helping more than 130,000 pet owners annually.
As I happily watched my friends prove me wrong, I thought a lot about the drivers of their success. I think the two biggest ones were:
- Pet owners wanted the service. They were more than willing to pay for veterinarians to come to their houses to provide end-of-life care.
- Veterinarians wanted to provide the service. The work is meaningful, the pay is good, and the schedule flexibility is attractive.
Dani and Mary enjoy reminding me of our conversation from oh-so-many years ago, and rightfully so. The lesson I learned from eating my big slice of humble pie was that in this country, if pet owners really want a service and veterinary professionals wish to provide it, it will almost certainly happen. The wheels of capitalism far outweigh the desires of veterinarians, regardless of how much influence we like to believe we have.
Veterinary Technicians and the Access to Care Equation
As I look at veterinary medicine today, I think the desire of pet owners for easy and convenient access to care is a tectonic force. Aren’t convenience and acccess what drives the push for online pharmacies, the home delivery of pet food, telehealth and even midlevel veterinary practitioners? The public demand is undeniable.
When we think about access to care, we must also consider veterinary technicians. Presumably, because of a significant reduction in the registration price this year, VMX had four times more technician attendees than usual. As a fan of techs, I thought their attendance was great, but seeing all those people reminded me of a downer conversation I had recently with a veterinary technology instructor.
She and I were talking about why more people aren’t coming through veterinary technician schools. My instructor friend told me how she talks to students considering the program. She shows them the average earnings of graduates from all the technical programs her college offers. She does it because she wants students to enter her program with “eyes wide open” about the realities of veterinary technology. However, the unfortunate reality is that most students see the veterinary technician salary next to the human echocardiology technician salary — the programs require the same amount of education — and politely choose the human option.
I asked my friend if she thought the pay gap was why we don’t have more credentialed veterinary technicians. She said, “Not really.” Her impression was that low pay didn’t help things but that the underutilization of veterinary technicians and a lack of empowerment turned people off. She thinks technicians often are as frustrated by not being able to practice at the top of their license as they are by the low pay.
As I consider where our profession is going, I can’t help but think about how the desire of pet owners for convenient and affordable veterinary care is going to intersect with the fact that veterinarians are slow and expensive to produce and that veterinary technicians are typically underpaid and underutilized. It reminds me strongly of how I felt sitting with Dani and Mary many years ago.
The role of veterinary technicians will change fundamentally in the coming years. Pet owners want easier, faster and less expensive access to care, and veterinary technicians want to be better utilized and earn a better living. For better or worse, the fact that many veterinarians do not want to give up their role as the sole outlet for pet health care will probably not matter.
I see the same reality as I look at telemedicine companies and online retailers and pharmacies, whose services pet owners want to consume. That combination of forces is a volcano inside our profession, and the volcano is erupting.
Volcanos and You
When I was a kid, volcanos terrified me. The idea that the earth could suddenly belch forth an unstoppable river of molten rock seemed like something we should all keep top of mind in our daily lives. Sure, scary things like kidnappers and monsters under the bed were worth keeping an eye out for, but what do you do about a river of molten rock?!
I recall asking my parents about our family’s plan for dealing with unexpected volcanic activity in our North Carolina neighborhood. The encyclopedia informed us that fast lava flows get up to only about 6 mph, while most were closer to a half-mile per hour. Given that our family had access to a car and regularly did brisk walks with the dog, I decided I could safely move the fear of volcanoes down my priority list.
I also learned that volcanoes create a lot of opportunities. For example:
- Magma breaks down into some of the richest, most fertile soil on earth.
- Many mined metallic minerals — gold, copper, zinc, silver and lead — are associated with magma and volcanoes.
Standing in the VMX exhibition hall, I understood that pet owner demands for convenience and access to care and the entrepreneurial interests in providing such services are tectonic forces. A volcano of change is erupting at the intersection. The lava flow is one of innovation and is coming down the mountain.
I Don’t Know Where I’m a Gonna Go
Today, veterinarians stand at a crossroads. We can either:
- Dig in our heels and try to hold back the lava flow.
- Throw up our hands and abandon the mountain.
- Accept that innovation is coming, that we have very limited power to stop it and that we must adjust so that we succeed in the new landscape.
Telemedicine, online shopping and home delivery are not going away. Veterinary technicians are going to be utilized in new ways that will provide easier access to care for pet owners and higher salaries for paraprofessionals.
My hope is that veterinarians will accept what’s inevitable. Changes we’ve never seen before are coming. I do not want us veterinarians to focus on trying to stop an unstoppable force or flee the profession and allow nature (and those riding the lava wave) to dictate what happens going forward.
I hope veterinarians will decide to migrate with intention. That we will adjust and try new things so we can continue to be relevant and successful long after the eruption ends. I hope we will seek ways to engage with telemedicine and online services that work for us and pet owners. I hope we will be a part of the technician revolution so that techs get to use their skills, improve pet owner access to care and make a living wage in ways that keep veterinarians, not private equity, at the center of veterinary medicine.
I don’t know where I’m a gonna go /
When the volcano blow.
– “Volcano,” Jimmy Buffett