Bob Lester
DVM
Creative Disruption columnist Dr. Bob Lester is the chief medical officer at WellHaven Pet Health, a former practice owner and a founding member of Banfield Pet Hospital and the Lincoln Memorial University College of Veterinary Medicine. He serves on the boards of Pet Peace of Mind, WellHaven Pet Health and the Lincoln Memorial veterinary college. He is president-elect of the North American Veterinary Community.
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Our current model of veterinary practice could be viewed as a great wooden ship. It’s carried us admirably over many years through seas fair and foul, from a profession dedicated to transportation (horse doctors) to one devoted to protein (farm animals) to one dedicated mainly to companionship. Our ship is comfortable and familiar, and it has stood the test of time. But is it the right vessel to get us to where we need to go tomorrow? The hull, after all, is wooden, today’s seas are much different than those our forebears faced and caring for beloved fur babies is dramatically different than caring for our predecessors’ animals.
What got us here might not get us where we need to be because today’s society is asking for more from our profession. Our ship was designed and built a century or more ago — before the internet, space travel and Elvis — and it still consists largely of one doctor in one exam room in one brick-and-mortar clinic seeing one patient every 20 minutes over and over again. So, is it time for a new ship? Have I stretched the metaphor too far?
Traditional vs. Modern
I consider myself a generalist who thinks best in broad terms. I’m a primary care provider, general practitioner and traditionalist. I’ve been fortunate to develop reasonable but not deep competence in a variety of veterinary domains. I have long been wed to the model of the general practice that does almost all things for almost all people. I went to school to become James Herriot. His model is the one we learned in school, and it has given us the success we enjoy today. I’m not eager to abandon the best wooden ship in the navy. However, what’s becoming clearer is that the old do-all-things-for-all-people practice model is increasingly difficult to work in, lead and administer, and satisfy growing consumer needs. Our model has become less and less attractive over the years.
Do we have to abandon the old, reliable wooden ship in favor of a new one? Do models in between traditional and modern exist? Goldilocks models? Can we combine the old and new and mix them into something “just right” for today’s veterinary professionals and clients? Build a hybrid ship to meet our needs and the needs of pet owners?
As I think about potential new practice models, they might be subdivided across several categories and perhaps lumped into broad groups like culture, team focus, species, the medicine practiced, business model and technology utilization. You can no doubt subdivide differently. Ultimately, consumers and veterinary professionals will choose between the categories to find the combo that best fits their needs and wants. So, let’s build a menu of practice models.
Take Your Pick
Our model menu might contain some of the following characteristics. Mix and match, combine and blend, mash traditional and modern. See what you come up with.
- Culture type: Top-down, bottom-up, consultative, directive, high autonomy, low autonomy, command and control, servant leadership, embrace change, resist change.
- Team focus: Vet-centric, pet-centric, tech-centric, client-centric, millennial-focused, boomer-focused.
- Species: Cat, dog, equine, exotic, mixed, breed-specific.
- Medicine practiced: General practice, specialty practice, urgent, emergency, house call, brick and mortar, virtual, shelter, walk-in, appointment, affordable, preventive, reactive, pop-up, hospice, outpatient, inpatient, high volume, low volume, high touch, low touch, AAHA credentialed, evidence-based, spectrum practice, gold-standard practice.
- Business model: Concierge, subscription, virtual, brick and mortar, house call, independent, corporate, private, group, partnership, nonprofit, membership, franchise, joint ventures.
- Technology utilization: Tech forward, tech resistant, cloud-based, server-based, client apps, social presence, wearables, artificial intelligence, data-driven, outcome-based, telemed, teletriage, teleadvice, synchronous, asynchronous.
If you were to build your ideal Goldilocks practice model and match it with what today’s pet owners desire, how would it look? I suspect you’d offer a mix of traditional and modern. Your ship might have wooden accents, a titanium propeller, GPS and other features old and new.
The Young Fleet
I submit that Goldilocks ships have launched and that more are ready to set sail from Charlotte to Los Angeles and New York to Seattle. They range from veterinary technician/nurse-driven practices to technology-forward practices, from corporate practices to independent practices, from vet-centric to pet-centric to client-centric, from virtual to brick and mortar, from traditional to modern, and everything in between. Dozens of new models are springing up, and all appear to be succeeding by meeting both the needs of veterinary professionals and pet owners. Examples include:
- Bond Vet: Daytime general practice and urgent care, and open evenings.
- Modern Animal: Tech forward and membership-based.
- Booster Pet: Wellness care delivered by veterinary technicians/nurses.
- One Vet: In person and virtual.
- WellHaven Pet Health (my employer): Team-based and doctor-led.
- Easyvetclinic: Walk-in and wellness service.
- UrgentVet: After-hours urgent care without an ER.
The list goes on. Pick your ship, customize it, sail on.
Among the myriad innovative and healthy new models entering the profession are several universal themes. Common to all are healthy cultures, healthy teams, technology enhancements and profitability. But most important and unchanged from the days of old wooden ships is a love of people and pets.
Where do we want tomorrow’s ships to take us? Forecasting is difficult but safe to say:
- The humanization of pets will continue.
- Reliance on technology will keep growing.
- Consumers will want more things faster and cheaper.
- The benefits of pets in families will become increasingly valued.
- The demand for our services will grow while the supply of veterinary professionals is finite.
What kind of ships will get us there? I don’t foresee an end to shipbuilding. Let’s keep innovating, learning (and failing at times), changing, listening and growing. Stay curious. Winners and learners will emerge. The veterinary marina has space for all. The wooden ships will still sail, but many new, innovative, exciting and novel seaworthy vessels will be alongside them.
Here’s to fair skies and following seas now and into the future. It’s a great time to be a veterinary professional.
PET PROS
Six of every 10 U.S. veterinary practices were companion animal exclusive in 2019, according to the American Veterinary Medical Association’s Economic State of the Veterinary Profession report. A practice is defined as such if at least 90% of the patient contact involves dogs, cats, birds (non-poultry) or exotics.