It's time for veterinary professionals to take back veterinary medicine

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The movie The Matrix presented the protagonist Neo with an option: He could continue to live in the world of a bland, warped nonreality by taking a blue pill or unveil the actual material world by taking a red pill. The latter choice would allow Neo to see the contorted reality of the world represented by the blue pill: distortions meant to keep the masses enslaved and shuffling through a veiled existence placated by placebo living.¹

The Matrix strives to share a message about the manipulation of the masses. The message of compliance propagated by the blue pill is of muted living and blind allegiance to perceived safety in opposition to the truth and critical thinking. The red pill pulls away the cloak of sedation and allows individual thought. The red pill is volatile and leads to the disorder of life, whereas the blue pill keeps individuals in a state of dull complacency. The blue pill creates a numbing facade that negates any desire except to live in the haze of whatever authorities want the masses to comprehend. The color blue itself belies a state of mind: depression, numbed emotions, and melancholy. The red pill awakens the deeper crevices of the mind and removes the ill-tinted blue glasses that blind individuals to the invigorating, meaningful parts of life. That is the crux of the story.

The veterinary profession has been given the blue pill

Veterinary professionals have enjoyed elevated status in many ways over the past 3 decades. There are a plethora of opportunities in veterinary medicine, and veterinary professionals don’t necessarily have to become clinicians; they can pursue careers in research, food inspection or military service or work for a veterinary company. Still, most veterinarians work within the companion animal space in veterinary clinics or facilities, which include large animal care. The profession is expected to grow by approximately 19% between 2021 and 2031.² Even with this projected growth of an additional 26,000 veterinary graduates by 2030, there is still an expected shortage of 15,000 veterinarians for the demand of care.³ In addition, veterinary salaries have increased in the past 10 years as the need for veterinary talent increases because of client demand and increased pet ownership. Veterinary pay is expected to increase by 8% to 12% in 2023.⁴ The increase in veterinary compensation is long overdue. Despite the level of education required to be a veterinarian, the profession is not as well compensated compared with other similarly educated medical vocations, with the primary reason being that veterinary patients are nonhuman. We also subsist on a cash basis, and pet parents do not always invest in third-party payers such as pet insurance.

So where is the blue pill in all this? The blue pill is easily hidden in pabulum concocted by a change in the culture of veterinary hospital management and operations. This is especially true for practices no longer owned by local, independent veterinarians but by corporations. The same reasons for lower salaries in veterinary medicine, such as cash-based business, minimized regulatory oversight, no third-party pay administration to insurance companies or government agencies such as Medicare, and the fragmentation of businesses, make it easy for corporations to pick off privately owned veterinary practices. As private equity began to buy veterinary practices in the past 30 years, prices for veterinary practices were driven out of the realm for associate veterinarians to afford. These practices find it much easier to sell to corporations for an immediate lump sum of cash than to seller finance an associate for buy-in or share equity. Initially, this seemed like a win-win for everyone. The owners were now allowed an exit strategy with cash for their retirement and the ability to continue working without shouldering all the management. However, even with this windfall, many of these former owners privately lamented that they had not sold to an associate to keep their practice and legacy in familiar veterinary hands. This process has ushered the veterinary profession into the blue pill era.

With the proliferation of corporatization in the veterinary profession, veterinarians are more often managed by nonveterinary professionals from other multiunit entities who come with no understanding or experience of the pet medical care world. With this new management comes the push for veterinarians to care for an excessive number of pets per shift with strict cost control, which results in fewer staff to assist the veterinarian. Inventory is managed to bare cupboards so that many prescriptions must be outsourced to online pharmacies, which decreases the ability of the veterinarian to achieve adequate production on medications prescribed. Veterinarian schedules are controlled with little regard to the mental health and wellness of the teams. The blue pill reality of this work environment has resulted in dissatisfied veterinary teams experiencing lack of fulfillment in their beloved profession, precipitated by less client interaction and constant oversight of their workday, which can lead to suicidal ideations because of the pressure to produce beyond personal and professional means.

Veterinary burnout is at an all-time high. It has been exacerbated by this standard, propagated under the guise of higher pay and the “don’t worry about managing” model within the veterinary medicine corporations.⁵ The blue pill seemed like a cure a few decades ago to free veterinarians to just be doctors. It has created an unsustainable trajectory affecting all professionals in veterinary medicine. This model of hyperscheduling, constant measurement, and increased scrutiny trickles into privately owned veterinary clinics, who believe this is how they must compete. This is unfeasible, opening a chasm of despair in which the blue haze reveals not the utopia of “more money, less worry” but the golden handcuffs of anguish.

Time for the red pill

Our beloved veterinary profession has been hijacked, and many of us live in the blue-veiled world. We entered willingly, hoping this model would enable veterinarians to manage medical cases more efficiently with less worry of business management, but it has created distress. The red pill is the world in which we uncloak ourselves and retake the business from the veterinary practice to the board room. We once again become the subject matter experts of the profession we labored 8 years or more to master through education in addition to the countless hours spent perfecting the art of practice. Although we welcome business acumen from outside the profession, in the red world, veterinarians are the medical and business leaders. Veterinarians schedule their client interactions as they see fit and hire and use staff without fear of reprisal. Veterinarians hire other veterinarians and mentor and coach them to success.

In this world, we return to our business knowledge, enhanced by veterinarians and staff. Ownership of veterinary facilities is either the fully owned or hybrid partnership model. However, in a red pill world with hybrid partnership, which may include private equity funding, the veterinarians are the subject matter experts. Nonveterinary management is in support roles and does not represent sole executive leadership. Veterinarians are empowered to lead, nurture, and grow animal care businesses as they have done for decades. Don’t be fooled; the interest in our profession is predicated upon the wealth that veterinary medicine produces. It’s our wealth. We need to step in and wrest it back from corporations and reclaim the joy and purpose of our profession. The rote, assembly-line practice that veterinarians have been shoehorned and blue-pilled into precipitates the sadness, weariness, and burnout that is too pervasive in our profession.

The blue specter permeates a veterinary profession co-opted by outside pillagers. So what will it be? The red pill or the blue pill? We get to decide, and the time is now.

Pamelar Hale, DVM, MBA, has held numerous high-level leadership roles within veterinary medicine, from chief of staff to chief medical officer. She is a graduate of the Tuskegee University College of Veterinary Medicine in Alabama and earned her master of business administration from St. George’s University in Grenada. She is a member of the American Veterinary Medical Association (AVMA) and the Georgia Veterinary Medical Association and serves on the Dean’s Council for Tuskegee University College of Veterinary Medicine and the AVMA Professional Liability Insurance Trust. She joined the Wedgewood Pharmacy Veterinary Advisory Board in 2022. She shares a home with 5 dogs and her husband, Chuck.

References

1. Chapter 1. overview: blue pill or red pill? Queensborough Community College. Accessed June 20, 2023. www.qcc.cuny.edu/socialsciences/ppecorino/intro_text/chapter%20 1%20introduction/blue-pill-orred-pill.htm
2. Veterinarians. US Bureau of Labor Statistics. Accessed June 20, 2023. https://www.bls.gov/ooh/healthcare/ veterinarians.htm
3. Sandoval E. Ripple effect of veterinarian shortage causing delays in appointments. Click Orlando. February 3, 2023. Accessed June 20, 2023. www.clickorlando.com/news/ local/2023/02/03/ripple-effect-of-veterinarian-shortage- causing-delays-in-appointments
4. Veterinarian salary survey results – January 2023. Veterinary Jobs Marketplace. February 13, 2023. Accessed June 20, 2023. www.vetpetjobs.com/blog/ us-veterinarian-salary-survey-results-january-2023
5. Hauser W. Beyond burnout. Today’s Veterinary Business. February 4, 2022. Accessed June 20, 2023. https:// todaysveterinarybusiness.com/beyond-burnout