Taking the pulse of 2011 and beyond

General practice remains at a crossroads; hastened by the economy, specialization
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Feb 01, 2011

National Report — Patient referrals won't be replacing examinations for veterinary general practitioners any time soon, but DVMs will need to learn new ways to work with clients—and each other— in a rapidly changing world.

"I think the veterinary profession, like many businesses, is kind of at a crossroads," says Dr. Peter Weinstein, DVM, MBA, executive director of the Southern California Veterinary Medical Association and partner at http://VeterinarySuccessServices.com/. "In many industries, high-tech or even the medical profession, everything can be going along just fine and then something happens and the business model has to change.

"Veterinary medicine has been the same for 30 to 50 years, until the last few years. The delivery model has to change."

General practitioner or gatekeeper?

"I still see a bright future for general practice," says Dr. Michael Andrews, chair of the Board of Directors at the National Council on Veterinary Economic Issues and owner of Woodcrest Veterinary Clinic in Riverside, Calif. "I would be hopeful it isn't going the route of human medicine. General practice can handle many cases that come up, but specialty practices still are valuable for special expertise and use of special tools."

General practitioners are critical to the overall care of patients, he adds, for getting the bigger picture.

"Someone needs to have an overview of a (patient's) treatment," he says. "When that gets scattered out over various specialists, that overview can be lost."

"I think the future is not clear, relative to general and specialty practice, but there are a couple things we need to think about," adds Dr. John Albers, former executive director of the American Animal Hospital Association who now owns the consulting company Albers Veterinary Strategies.

During the recession, Albers says specialty practices suffered more than general practices, with general practitioners opting to keep more complicated cases in-house. Specialty practices number a lot higher than in year's past, so there is actually a decline in specialty practices that could be attributed to both the economy and possible saturation in the profession.

"How many specialists does the profession really need?" Albers asks. "I really have no idea if we're at that saturation point."

Some practices are opting to hire specialists to keep that revenue in-house, and Albers questions how many specialists can be supported within private practices.

But some lessons can be learned from human medicine, specifically how the general veterinary practice of the future works with specialists, Weinstein says.

Veterinary general practices need to change, he says, but that change is not a move toward becoming referral practices. Instead, veterinarians may need to look at adopting the physical set-up commonly used in human medicine.

"What I would like to see is more doctors in larger facilities providing general practice care, allowing for higher quality of life and more efficient delivery," Weinstein says, comparing this model to medical office buildings in human medicine where general practitioners are housed in the same facility as various specialists. "Having veterinarians learn to play together in a common physical plant delivering quality care and service, sharing equipment, sharing supplies, maybe even having their own technical staff I think is a model we have to look to. There is a tremendous amount of inefficiency in a single veterinary practice."

This model also would help general veterinary practitioners achieve better work/life balance—a strong consideration with the "genderational" changes occurring in the veterinary profession, Weinstein says.

"I think you're going to find different types of employees, but I think the model of veterinary medicine 25 years ago, working 60 to 80 hours a week, is not acceptable for anyone, especially with the returns on investment it provides veterinarians," he says. "We're seeing less desire to physically subject, and mentally subject, yourself to the 60-hour work weeks that baby boomers are willing to put themselves through.

"I don't see the current model as broken; I just don't think it's going to withstand all the pressures and changes that are going on around us. I think there's going to be a need to rethink how we deliver veterinary medicine," Weinstein adds. "I still think specialists and referral medicine will be part of the mix, but I'm not sure veterinary medicine will be a gatekeeper like in human care."