Negative views of the veterinary profession make "spin" necessary

I am tired of being lectured to by Mark Opperman. I have been practicing veterinary medicine for 25 years and have owned a successful multi-doctor practice for 24 of them. One thing has not changed in all of that time: The vast majority of my clients still reach into their wallets to pay for my services with discretionary dollars. Pet insurance makes up less than one-half of 1 percent of my transactions. And median household income has fallen over the past five years and shows no signs of imminent recovery. People who follow the advice of Mr. Opperman and his intellectual choir seem to be operating in economic Wonderland and are taking the profession to a difficult place, in my opinion. Transparency should not be the issue that concerns us. Facing economic reality should be.

Fifteen years ago, veterinary practices enjoyed a virtual monopoly on product sales and wellness care, supported, in part, by state practice acts, which restricted our products and services to veterinarians. It also helped that drug companies saw value in marketing their products exclusively through veterinarians-a favor which some of us returned by marking up these products 2.5 to three times. The Internet had not yet become a significant competitor, either for product sales or professional advice. We were encouraged to raise our prices with impunity. We were told that it is impossible to spay a cat for less than $200 and still make a profit. In short, we followed bad advice and failed to keep up with a changing market and a changing economy, creating an economic vacuum.

Nature abhors a vacuum, and so does free-market capitalism. It didn't take long for entrepreneurs to discover that they could make huge profits selling flea and heartworm products at a fraction of what we used to charge, armed only with a computer, a pole barn and a few minimum-wage shipping clerks. Nonprofit humane organizations, tired of euthanizing thousands of homeless animals each year, discovered that it was, in fact, possible to spay a cat for much less than $200 and remain solvent. For years they had asked us to help them out, and many of us turned a blind eye. So they just went around us, taking a chunk of our wellness care with them.

Our profession still enjoys a reputation for altruism among most of the public; irrespective of the media hit pieces Mr. Opperman refers to. Over the years, we've ridden the wave of change in how people view their pets, from critters kept outside in doghouses and barns, to beloved family members who share our beds. The strengthening of the human-companion animal bond has mostly served to enhance the reputation of our profession, as we have partnered with pet owners to increase their pet's longevity and quality of life. But it should not be taken for granted. The bond has the potential to work against us, as more and more of our clientele are forced to make difficult economic decisions about treating their beloved pets or putting food on the table.

The way we maintain our profession's position of respect in the community must always be grounded in a commitment to quality medicine. But we must be equally committed to ethical business practices and a focus on offering value and affordability to our clients. These concepts need not be viewed as mutually exclusive. Transparency will only hurt those of us with something to hide.

Stewart Smith, DVM, PhD

Cincinnati, Ohio

I just read the article on financial transparency in Veterinary Economics and the lack of “spin” from our associations-great job! I spoke to an association board member at a conference two years ago and said, “We need a campaign to tell owners why they need vets.” Her response was, as Mark said, no money. My reply was that social media is free and we need to use it.

I emailed your article to a couple of board member friends. I hope they will start the ball rolling and I believe they will. But thank you Mark for saying what needs to be said! I know we all love this profession and battle to keep practices essential in the lives of pets and their owners.

Debbie Boone, BS, CCS, CVPM

2 Manage Vets Consulting

I have been employed in the veterinary field for more than 40 years, and I truly believe that everyone in this industry needs to read this article. It doesn't surprise me that Mark Opperman is the one to finally the one to bring this subject out in the open for all of us to see. Instead of being proud of what we do, for years we've made excuses about why we charge for what we do in our profession.

As a veterinary management consultant for 20 years, I'm tired of explaining to hospital owners that we shouldn't be ashamed of charging a fair price for what we do. I once had a client throw a dog across the counter at me and say, "What do you think this is-a real hospital?" Well, yes it is!

Our organizations need to find a way to show people that veterinary medicine is a business and if we can't make money we can't continue to spend 24 hours a day taking care of their pets.

Carol Sapp, CVPM

Keystone Heights, Florida

I read with interest your thoughts on the transparency of the profession with regard to generating income. Of course, you're taking [veterinary medical associations] to task for not speaking up on behalf of veterinarians and their generosity. Point well taken.

You're right-we don't have enough money to combat this issue as much as we'd like. There is more that we could do. My experience is that veterinarians are reluctant to discuss their generosity and benevolence with clients, in part out of concern that other clients who haven't been on the receiving end will come forward and ask or demand that they also get discounted services. But also because veterinarians just do what they do without any fanfare.

Thanks for the wakeup call and the kick in the rear!

Glenn Kolb

Executive director, Oregon Veterinary Medical Assoc.

Thanks again for another thought-provoking issue. I have to wholeheartedly side with Mark Opperman on this topic. I've been quietly lamenting and speaking aloud for years about our associations' lack of support or spin for all of us on the front lines. I'm a 1981 University of Florida graduate and have watched our public image go from No. 1 trusted profession to ... ?

Dr. Greg Magnusson's suggestion (Don't feed the trolls, June 2014) to ignore these insults brings to mind the now-defunct advice we all got to ignore bad Internet reviews: NO-don't do it!

I took early retirement last year, as I knew I had "drunk the Kool-Aid" and was having a hard time showing my clients the "perception of value" versus the real value for my services. Time to bow out! May my younger colleagues see the value of associations and a collective voice to uphold this noble profession. After all, it is a calling, is it not?

Lynn Duffy, DVM

Venice, Florida

I want to take a moment to compliment Mark Opperman for his piece, "Is veterinary medicine too transparent?" First off, as the veterinarian/consultant that was blindsided by the Canadian television crew in Banff, I am more than sensitive to the topics that he addressed in the article. I had been speaking on this topic, "Talking to Your Clients about Money" for a number of years. The unfortunate thing lost in the tumult is that the premise of my presentation was veterinary practice must be a client and patient advocate first and then the money talk is easy. The fact that I talk about this issue is so onerous to some pet owners that I even have a negative YELP review written about my former practice, where I haven't worked since 2000. So, transparency got me into trouble. But it doesn't stop me.

The first significant point that that I support whole heartedly is the failure of organized veterinary medicine and the local, state, and national associations to be the public advocates and cheerleaders for this profession. Letters, tweets, Facebook posts and website accolades do little to impact the public perception that has recently been questioned. We are no longer a protected profession. The public trust has been violated and the consumer support that we have long had has eroded. Both individually and more so as a profession, we need to be out there expounding on the great things that we do. The veterinary profession has been hiding under a rock for too long and we need to be advocates for ourselves. Who better to do so than the organizations that we pay dues to be our advocates?

The second point involves veterinary students. Current and future veterinary students are the foundation of this profession for the future. They're also a part of the generation that isn't really joiners of organizations. Associations of all kinds are being challenged by membership attrition at the top and a failure to integrate the youthful members at the bottom. Whether it is student disinterest, generational disinterest, or failure to engage and enrapture by organized veterinary medicine, it doesn't matter. It is imperative to enroll our students and young veterinarians in organized veterinary medicine, get them involved, encourage them to become leaders and help them control their future and the future of our profession. And concurrently get them to be cheerleaders as well.

Rather than chasing the next new shiny object and some one trick pony that will possibly increase transactions, let's focus on us, veterinary medicine. It really irks me how little the animal owning population knows about the breadth and depth of animal healthcare. When I was talking to a consumer the other day and mentioned diabetes and cancer and they said, "pets get diabetes and cancer? And you have specialists in Dermatology and Oncology? I didn't know that!"

Mark thanks for opening up Pandora's box and starting the conversation. I am in your corner all the way.

Peter Weinstein, DVM, MBA

Irvine, California

Mark, what a direct hit! My clients don't know what the value of a hospital association is and whether I'm doing a good job. I'm very interested to see what the response to this article will be by the profession and the AVMA.

John Heidrich, DVM, PhD

Albuquerque, New Mexico

I am tired of being lectured to by Mark Opperman. I have been practicing veterinary medicine for 25 years and have owned a successful multi-doctor practice for 24 of them. One thing has not changed in all of that time: The vast majority of my clients still reach into their wallets to pay for my services with discretionary dollars. Pet insurance makes up less than one-half of 1 percent of my transactions. And median household income has fallen over the past five years and shows no signs of imminent recovery. People who follow the advice of Mr. Opperman and his intellectual choir seem to be operating in economic Wonderland and are taking the profession to a difficult place, in my opinion. Transparency should not be the issue that concerns us. Facing economic reality should be.

Fifteen years ago, veterinary practices enjoyed a virtual monopoly on product sales and wellness care, supported, in part, by state practice acts, which restricted our products and services to veterinarians. It also helped that drug companies saw value in marketing their products exclusively through veterinarians-a favor which some of us returned by marking up these products 2.5 to three times. The Internet had not yet become a significant competitor, either for product sales or professional advice. We were encouraged to raise our prices with impunity. We were told that it is impossible to spay a cat for less than $200 and still make a profit. In short, we followed bad advice and failed to keep up with a changing market and a changing economy, creating an economic vacuum.

Nature abhors a vacuum, and so does free-market capitalism. It didn't take long for entrepreneurs to discover that they could make huge profits selling flea and heartworm products at a fraction of what we used to charge, armed only with a computer, a pole barn and a few minimum-wage shipping clerks. Nonprofit humane organizations, tired of euthanizing thousands of homeless animals each year, discovered that it was, in fact, possible to spay a cat for much less than $200 and remain solvent. For years they had asked us to help them out, and many of us turned a blind eye. So they just went around us, taking a chunk of our wellness care with them.

Our profession still enjoys a reputation for altruism among most of the public; irrespective of the media hit pieces Mr. Opperman refers to. Over the years, we've ridden the wave of change in how people view their pets, from critters kept outside in doghouses and barns, to beloved family members who share our beds. The strengthening of the human-companion animal bond has mostly served to enhance the reputation of our profession, as we have partnered with pet owners to increase their pet's longevity and quality of life. But it should not be taken for granted. The bond has the potential to work against us, as more and more of our clientele are forced to make difficult economic decisions about treating their beloved pets or putting food on the table.

The way we maintain our profession's position of respect in the community must always be grounded in a commitment to quality medicine. But we must be equally committed to ethical business practices and a focus on offering value and affordability to our clients. These concepts need not be viewed as mutually exclusive. Transparency will only hurt those of us with something to hide.

Stewart Smith, DVM, PhD

Cincinnati, Ohio

I just read the article on financial transparency and the lack of "spin" from our associations in the June issue of Veterinary Economics. Great job! I once told a board member of the American Animal Hospital Association that we needed a campaign to tell owners why they need veterinarians. Her response-as Mark said-was that there was no money. I told her that social media is free and we need to use it.

Thank you Mark for saying what needs to be said! I know we all love this profession and battle to keep practices essential in the lives of pets and their owners.

Debbie Boone, BS, CCS, CVPM

2 Manage Vets Consulting