Veterinary schools take varied approaches to satellite clinics

When The Ohio State University College of Veterinary Medicine opened its first emergency and specialty satellite clinic in Dublin, Ohio, on April 29, it was following in the footsteps of several other veterinary colleges across the country. While many of these satellites have been welcomed with less-than-open arms in the local veterinary community, the schools insist they need new outlets for clinical cases and revenue—and so they seek to maneuver a path to peace with they colleagues they rely on for referrals.

An educational mission

Kansas State University College of Veterinary Medicine opened MidWest Veterinary Specialty Hospital in Omaha, Neb., five years ago. But the process started about 20 years ago, says Ralph Richardson, DVM, dean of the K-State veterinary college, when the school began seeing its caseload decrease as private specialty practices emerged. “We believed if specialty practice continued to grow, there would be a point when K-State would lose access to what we call our ‘four-legged textbooks,’” Richardson says.

At first, Wichita, Kan., looked like a promising site for a specialty clinic. Although research proved it a viable market, some local veterinarians voiced concerns. “We felt we were in a divisive position—many of them were alumni—so we pulled back from that market exploration,” Richardson says. However, another area—Omaha—requested consideration. So the plan shifted.

Richardson says that by listening to what veterinarians wanted, the college shut down much of the backlash it was receiving in Wichita and that other satellites, such as Ohio State’s, are currently enduring. “We did it in cooperation with community veterinarians and No. 1 we did it for the purpose of teaching,” Richardson says.

Ohio State, meanwhile, has been accused of circumventing local veterinarians’ concerns and creating the satellite primarily to generate revenue. “It’s a facility we hope will make money,” says Melissa Weber, spokesperson for the college of veterinary medicine. “It’s money that will take care of the medical center here on campus.”

While Ohio State opted to provide both referral specialty service and 24-hour emergency care, Richardson says the Omaha community didn’t want a K-State emergency clinic. “We’ve been very careful to provide referral-only care,” he says. “We set [the satellite] up next to the only emergency clinic in the area at that time.”

Richardson says that by all accounts the clinic has proved successful, providing the local veterinary community not only with specialty services but continuing education and professional networking opportunities. “We’re not there to see how much business we can do,” he says.

The college funded the project by creating a not-for-profit organization that took out a loan from the Kansas State University Foundation. “There is no economic advantage for us,” Richardson says. “The not-for-profit is an organization that supports educational programs in their broadest sense. It enhances the learning environment outside the university.”

Like Ohio State, K-State’s clinic is an elective rotation for students, and Richardson says a large number sign up. “It’s a wonderful teaching environment,” he says. “There are [students] involved in all aspects of care.”

A new model

Other university satellites are not so education-based. Like Ohio State, Cornell, which opened an emergency and specialty veterinary center in Stamford, Conn., in January 2011, keeps students in an observational role only. Both universities found that the hands-on approach of a traditional teaching hospital slowed the process for clients.

“It’s not what all clients want,” says Susan Hackner, BVSc, MRCVS, DACVIM, DACVECC, chief medical officer and chief operating officer of Cornell University Veterinary Specialists (CUVS). “It’s not sustainable in a for-profit model. Everyone has busy lives and they want to come in and see a specialist who’s top in their field and want to get out of here. They love that we have students, but they don’t want to discuss surgery with the student; they want to discuss it with the surgeon.”

Cornell’s satellite is a 20,000-square-foot facility whose mission, Hackner says, is to be the best of academia and the best of private practice in one place. Cornell wants to offer the innovations and talent found in academic hospitals but the systems, service and efficiencies of private practice. “Many veterinary colleges feel there’s a need for an alternative model for emergency and specialty veterinary care in the profession,” Hackner says.

Like K-State, Cornell was experiencing a decline in its specialty caseload and determined that a satellite in a densly populated area would improve numbers. And like Ohio State, Cornell opened amid mistrust about its intentions and motivations. “We opened with some enthusiasm but also trepidation—even blatant hostility,” she says. “I think we put those concerns to rest very quickly.”

In an effort to acknowledge the feelings of some private practice owners that universities have a financial advantage with nonprofit status and low interest rates on financing, CUVS decided not to go the nonprofit route. “For that reason, we are a for-profit,” Hackner says. “We made a very conscious decision that this would be a for-profit facility.” However, the profit the facility earns goes to Cornell’s College of Veterinary Medicine.

Hackner says the satellite operates as any other veterinary hospital would. It does not accept donations and pays its loan from the university back. “We’re for-profit, but that’s not our mission,” she says—rather, the facility wants to be known for education, medical excellence and being a good member of the community.

“I think what has helped us is being very clear internally and externally that we are a mission-driven hospital,” Hackner says. “We’re also extremely careful with our relationships with veterinarians in the area that we don’t compete with them in any way, shape or form.”

CUVS does not offer any general practice services and tries to be open and available to local veterinarians, Hackner says. “Our veterinarians can go online to look at veterinary records,” she says. “We’re very transparent and very communicative.”

But she’s still surprised by backlash from veterinarians when it does occur. “Private entrepreneurs open a practice and nobody says, ‘How dare you?’” she says. “I think people especially in this economy are scared.”

Moving forward

Hackner says she encourages veterinarians to call her and provide her with honest feedback about CUVS. “We’re here to make sure animals are getting the best possible care,” she says. “The more of us out there the better to educate and let people know what’s out there. It seems to me we’ve focused on the wrong issues.”

Likewise, Richardson believes the university satellite model—like K-State’s satellite—can be positive in a veterinary community. He attributes K-State’s success to a dedication to the college’s academic mission and effective communication with community veterinarians. “Not everyone will be supportive but you want to be very transparent in your operations,” he says.

Satellites

UC-Davis: UC Veterinary Medical Center, San Diego

Cornell: Cornell University Veterinary Specialists

Florida: Ocala PETS Clinic

University of Illinois: Chicago Animal ER

Kansas State: MidWest Veterinary Specialty Hospital

Mississippi State: Animal Emergency & Referral Center

Ohio State: Veterinary Medical Center at Dublin

Oregon State: Oregon Humane Society

Tufts: Tufts at Tech Community Veterinary Clinic

Washington State: WSU Spokane Specialty Clinic

Western University of Health Sciences: Banfield Pet Hospital