DVM Newsmakers: 'Remember theTitans;' Big practice, big medicine: Is the standard of care changing? - DVM
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DVM Newsmakers: 'Remember theTitans;' Big practice, big medicine: Is the standard of care changing?


DVM360 MAGAZINE


With that said, DeCarlo says many external forces work to change the level and sophistication of medical delivery — from malpractice claims and new government mandates to the changing expectations of pet owners. There also are extremes in the quality and level of medical delivery in this country, he says.

"There are many challenges in the way veterinary medicine is delivered from the country doctor, to university-level medicine to the level of training veterinarians receive while in school. Is someone or some outside group going to dictate the standard of care? I don't have an answer, but it is a huge question," he adds.

But as this level of sophistication grows, it might push practices into further consolidation just to keep pace with pet owner needs and technological developments.

Sophistication comes with a price.

Tough road When DeCarlo and Trotter sat down to plan out the elements of their new hospital, it was based on a mutual decision to take their practice to the next level.

"We had really kind of overfilled the building we were in. I didn't feel there was any reasonable strategy with the kind of place we had to stop growing without actually shrinking. In other words, if you are a referral practice and you start refusing patients, then why would those other practices continue sending anything over? We had to make a decision to either continue to expand or end the process. We decided to continue."

The next stage was to find a piece of property. It took about a year, and there was a catch. The elderly property owner wanted to lease the land to the practice and sell it upon her death. DeCarlo and Trotter wanted the property, so they moved forward. It was this detail in dealing with the first bank that would pose numerous delays for the project as well as create a feeling of loss of control over the direction of the practice. They were soon on a refinancing trail.

"We had two problems with financing. There was nothing to compare this hospital to. How can we compare the value of this building to others when there aren't any? The second part is they felt uncomfortable with the fact that the property wasn't owned. That was a huge hurdle."

Initial delays in financing and construction were taking its toll on staff morale.

They rolled the dice.

"We went out on a limb and started the project without bank money. We actually had the steel frame up before we got our first installment from the bank. It was a big gamble on our part. But if my staff didn't see a shovel going into the ground, I think they would have been pretty frustrated."

The gamble paid off. The practice moved into the new building in late 2004.

For DeCarlo, success isn't defined by a building.

"Anyone's success should be based on the fact that their personal life is growing and moving in a forward direction. I think if you start measuring success, then you just start failing. I don't have an endpoint. I am not saying that I just want to get bigger and make more money, I am saying it's more about quality."


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Source: DVM360 MAGAZINE,
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