Adapt your veterinary practice or die

"If at first an idea is not absurd it is not worth considering." — Albert Einstein

The sky is not falling. There are wonderful times ahead in veterinary clinical medicine. But you'll need to adapt to survive.

Failure to change

History is full of businesses that failed to adapt as well as businesses that managed change well. Borders, Montgomery Ward and Circuit City are gone. Southwest Airlines, Walmart and FedEx live on.

Mature businesses can struggle to find new revenue. During lunch in Ames, Iowa, proprietors of hamburger joints will sell only so many hamburgers in any one lunch hour. So to increase sales they must attract buyers from other hamburger places. Subway has done this nicely as it has more franchisees than McDonald's.

McDonald's hamburger business sales are mature, but they've reinvented breakfast. Breakfast is a new business for them, not a mature business. McDonald's is thriving while competition seeks traction in this sector.

How veterinary medicine changes

For those of us in veterinary practice, gone are widespread equine tube worming, large animal pharmacy sales, hog cholera vaccine revenue, pin firing, 10 lead ECGs, overpriced vaccines, Pentothal, halothane and 3-by-5-card medical records.

Currently fading is the small animal pharmacy, diazepam, doxorubicin and easy financial success.

Consider that in 1900 veterinarians worried that the bicycle would put the horse out of business. Then came tractors. But what emerged in equine veterinary medicine today is the thriving recreational horse industry—and of course my new Dutch Warmblood dressage horse is a good illustration.

Swine medicine went from hog cholera vaccine to production medicine.

Individual food animal care morphed to production medicine.

Artificial insemination has gone to technicians and embryo transfers to veterinarians.

Equine tube worming has gone to colic surgery.

Dental work on all species has emerged as the iPad—a "wow" product—of the last decade.

Forty years ago who would have guessed that folks would spend treasured coin on a KE apparatus for a barnyard chicken named "Chickie"?

We've seen small-town and out-of-the-way mixed animal practices morph into specialty practices accredited by the American Animal Hospital Association.

We've seen the behavior specialty emerge.

Veterinary technicians have become a dominant part of veterinary medicine.

We've seen ambulatory medicine services go into fixed facilities and now ambulatory medicine start to emerge again. A stark illustration of this is the niche of at-home euthanasia.

The "traditional" veterinary practice still exists, but we also have feline-only, emergency, specialty and avian practices.

Pseudorabies in pigs has been replaced by PRRS.

In small animal medicine we've gone from distemper to parvo to dental.

We veterinarians are a creative bunch.

20 issues driving change

Here are some of the top factors influencing our profession.

1. Growing niches. Where will you need to be in 10 years? What skills, equipment and training will you need for your medical interests?

2. More specialties. The specialty may be recognized by the AVMA or create-your-own-special-area. Interest in behavior long preceded the AVMA specialty group.

3. Debt. On all fronts personal and business debt will either limit success or create opportunity. Are you ready to use debt wisely?

4. Smarter shopppers. The informed consumer is a growing opportunity for practices willing to staying current.

5. Government-entitlement spending. This issue presents new challenges for all sectors of the community, including businesses. Be careful.

6. Consumer pushback. Clients will phone-shop and pry into every practitioner's fees. People look for the best physician to perform heart surgery, but we see pet owners who challenge estimates, look for "cheaper" surgery fees and diligently review invoices.

7. Fractured dollars. The beloved attachment to a single local veterinarian is being challenged. Consumers will turn to two, three or more veterinarians and different venues for their desired veterinary services.

8. Dr. Google. 'Nuff said.

9. Walmart's $4 prescriptions. The Wall Street Journal said these would turn the pharmacy industry upside down. It's happening. Find a way to thrive with this change.

10. Corporate practices, independent practices. Both will do nicely.

11. The importance of options. Open up your mind to consider the many ways to address medical and surgical issues. Consumers know there are a variety of options to diagnose and treat conditions. Veterinarians who offer these options will be the winners.

12. Regional adaptation. Cookie-cutter practices may exist in certain niches, but each locale has its own unique features. Take advantage of the opportunities in your area.

13. Consumer preference. Pet owners are looking for a combination of James Herriot and the Mayo Clinic. Can you offer that?

14. Knowing who you are. Look in the mirror and decide the medicine you want to practice. Then build your business plan.

15. Earning your success. You can define success many ways, but success is your responsibility in all areas of life.

16. Choosing your business. You can think of your practice selling commodities with a helping of customer service or selling just great service. It's your practice and your choice.

17. Your business plan, including compensation program. Care must be taken to take into account facts, fantasies and fads when developing your business mission.

18. Lemons. Life will serve you lemons. How you make lemonade is up to you and that will be your legacy

19. The key. You need to give consumers a reason to find you.

20. The world is yours. Go get it. Adapt to thrive.

Dr. Riegger owns Northwest Animal Clinic in Albuquerque, N.M. He can be reached at nwanimalclinic.com, by e-mail at riegger@aol.com or by calling (505) 898-1491.