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?


While the professional trend is to upscale existing facilities, it doesn't always translate into what clients really want, says Dr. Anthony J. DeCarlo.
"You learn over the years to divide people into a lot of different ways. One of the ways is that there are people who just move ahead and others that might analyze things to death and not do anything. We are kind of the first. From the day we opened the business, we never thought about how much money we would make; we thought about getting to work and making each day better."

The philosophy has garnered the practice a 20-percent growth rate every year since its birth in 1986.

Interestingly enough, DeCarlo doesn't worry so much about the financial aspects of the business. He and Trotter hired a chief financial officer to help keep them on track and figure out new ways to offer more benefits to employees.

His longstanding guiding ethos is that all of the practice's decisions are based on what's in the best interest of the patient and client, not the bottom line.

Though he declined to comment on its practice gross, one can imagine that maintaining such a large facility is an expensive proposition. Just consider these monthly expenses:

  • Electric: $3,750
  • Gas: $2,500
  • Water: $2,000
  • Health insurance and dental: $39,000
  • Most expensive piece of equipment: linear accelerator, $180,000.

Anatomy of a giant
"When you move into a 58,000-square-foot building, the cost of garbage pails is pretty astounding to put in perspective," he laughs. They spent $2,500.

The reality is, this practice needs patients. And they are getting them. Close to 130,000 animals will move through Red Bank Veterinary Hospital doors a year. Client numbers are estimated at 300 to 400 outpatients each day.

Management mistake No. 1, DeCarlo says, is to look at gross revenue as a barometer of success. "That's not the way I look at things. My feeling is that if you start looking at how much you have to make, you are making some bad decisions. As long as you hire the right people, offer the right services, the rest happens."

To prove the point, DeCarlo and Trotter foster an enriched environment for staff and clients. It's paid off. During a 19-year period, the practice has only lost six permanent doctors. To keep morale up, extras where built into the facility, such as a fitness center, a catered kitchen and a spread of employee benefits. For clients, he offers valet parking, among other things.

And even though he and his partner built this massive hospital, DeCarlo says bigger hospitals don't always translate into delivery of better medicine; it's about the people in the hospital no matter what size.

Changing market While practices are consolidating and growing in size, DeCarlo says it would be a professional detriment if personal client attention gets lost in the transition — a quality attribute he bestows on more traditional practices.

He readily admits that the trend might be to build upscale multi-doctor hospitals, but it is not always reflective of client wants. Remember that about 70 percent of the profession is based on the model of a two- to three-doctor practice size, he says. "One of the problems in this country is that businesses don't really consider the needs of the average consumers. There are clients who love two-to-three doctor practices, and the only reason they come here is to get a certain level of specialty care and equipment. They will go back to their practice because that is their style."


Source: DVM360 MAGAZINE,
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