Pervasive inefficiency in veterinary clinics - DVM
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Pervasive inefficiency in veterinary clinics
Being busy in a veterinary hospital doesn't mean being productive—or profitable.


Working overtime—but not working enough

On average, veterinarians in clinical practice are working overtime—more than 40 hours per workweek—despite this excess capacity. This paradoxical situation has developed, to some extent, because practices have extended their hours to provide non-emergency services. In addition, indivisibility of labor is a problem in all healthcare fields. Plus, using the most efficient amount of labor is much more difficult in veterinary practice because most are relatively small or, in the case of large animal practices, provide ambulatory services. This, of course, will go on indefinitely until the marketplace corrects itself in some dramatic way.

Although there has been a decline in solo practice over time, it still remains a dominant model in veterinary medicine. I believe two factors put solo practitioners at a disadvantage:
> Animals get sick 24 hours a day.
> The cost of practicing high-quality medicine, especially in terms of staffing and equipment, has skyrocketed.

Owners of smaller practices cannot effectively and easily spend time managing their hospitals and at the same time remain responsive, compassionate animal healers. In addition, they can't match the salaries and benefits of other businesses they compete with for labor. Few veterinarians want to give up client time for management time.

But the problem of appearing to be busy while remaining unproductive is ever-present in veterinary medicine, even in larger hospitals. Excess capacity exists because of inefficiency. The delivery model is broken and it has been for some time. In our profession, excess capacity is related to overcapitalization. That is, there is too much brick and mortar and equipment spread out over too many practices. Our profession is a mile wide and an inch deep.

Possible solutions

Here are a few solutions that could alleviate the problem:

Consolidate. This will create better efficiencies in professional management, labor and capital for the profession. Unfortunately, veterinarians will lose some control. This will be a bitter pill for some to swallow, but the benefits outweigh the bitterness.

Close veterinary schools. The growth in the number of veterinary graduates during the past 20 years has not been driven by the public's need for more veterinarians but by the universities' need to compensate for declining federal and state revenues. If capital resources remain stagnant or decline further, academia may not be able to sustain all the veterinary schools now open.

Close instead of sell. The number of "no-lo" practices—those with little or no value—is growing, and an excess capacity of veterinarians will exacerbate this trend. Expectations of current practice owners to sell these practices are high in spite of reality. After all, an owner has devoted years or decades to his or her practice. It only makes sense that it's worth a lot of money, right? Closure is an option.

Too many veterinarians

With excess capacity, along with student debt, there is only one inescapable conclusion: we need fewer graduates and more efficient service delivery in the marketplace. Getting there will be difficult. Veterinary schools need to look beyond the government and the student for support. They should restrict enrollment and consider adopting a more aggressive hybrid business-client model that more realistically reflects delivery costs. We will surely see the closure of some practices and mergers and consolidation of others. The marketplace will sort this out and there will be gnashing of teeth. We are peering over a cliff and must watch our step. One thing is sure: there will be more studies.

Dr. David Lane owns and manages two practices in southern Illinois. He is a consultant, speaker and author of numerous veterinary management articles. He can be reached at


Source: DVM360 MAGAZINE,
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