The golden age of veterinary medicine (Proceedings)
Our profession has had its ups and downs over the years. We have seen periods of perceived shortages and excesses of practicing veterinarians. We have moved from a profession of mostly male, large animal practitioners to one of mostly female, companion animal practitioners. The human-animal bond has been better understood and developed so that our pets have moved from the barn in the 1950's into our bed by the 1990's.
Today, we have some 80,000 veterinarians in the United States with about 65% in companion animal practice. About 5% of the companion animal practices are corporate practices and 95% are private practices. The average size of private practices is about 2 veterinarians according to AVMA.
Quality of life has become an important issue for practitioners. In the past, many owners and associates worked 50 or more hours a week in addition to being on emergency call. Today, new graduates want to work 40 hours per week or less with no emergency duty at all. Many would like to not work on Saturday and have one or more long weekends per month (Friday through Sunday off). The value of a private life has become more important than income to some people.Studies from AVMA and AAHA have indicated the more hours worked, the more money is made. There seems to be a disconnect between living a good lifestyle and repayment of debt. The mean educational debt in 2009 was $129,976 as reported by AVMA (JAVMA, 235, Sept. 1, 2009). The mean starting salary for small animal exclusive practice in 2009 was $69,154 (JAVMA, 235, Sept. 1, 2009). The ratio of debt to starting salary is now approaching 2:1. The issue of student debt to starting salary has been discussed by several different groups and associations (AAVMC, AVMA, AAVC, AAHA ). The real issue seems to be low income not the level of debt. The level of debt is similar to medical or dental school debt; however the starting salary is not a good measurement of return on investment (ROI). Most of the discussions have centered on starting salaries and not career income potential.
Another factor in the growing student debt issue is the generational differences between today's graduates and graduates of 20-30 years ago. Newer graduates want to work fewer hours and may not be as interested in ownership due to the increased work hours usually required of ownership. This trend seems to cross the gender line as both males and females seem to share this feeling. Veterinary schools have about 80% females in current classes. The gender shift and generational differences seem to make today's graduate more likely to seek work that has controlled hours, nights and weekends free, retirement programs, mentoring programs and benefits programs. These requirements are often not provided in smaller private practices.
In the past 10 years, specialty practices have also entered the picture. This requires the new graduate to continue their training another 3-4 years (Internships/Residency) but allows the potential of a higher income on completion compared to private general practice ( JAVMA 234, Jan 1, 2009 ). However, the additional training may increase the debt load, or at best, delay repayment of student loans. Approximately 43.5% of new graduates are now entering some form of advanced training (JAVMA 235, Sept. 1, 2009).
Specialists have many opportunities for employment including academia, industry, specialty practice or corporate practice. Often, the qualified specialist must make their employment choice based on the level of income due to the large debt repayment obligation. This choice often does not allow the newly trained specialist to be employed by teaching institutions due to the lower salary paid compared to private practice and industry. Therefore, many teaching hospitals are finding it difficult to hire specialists. This has sparked concern over who will teach the new generation of veterinary students and specialists?
Since the introduction of the larger corporate practices starting about 15-20 years ago (i.e. VCA with 470 + practices, Banfield with 750 + practices, and NVA with 120 + practices) the opportunity to have a controlled work week, minimum management duties, retirement plan and benefits has changed the employment picture for both new graduates and specialists. Practices that have one or two veterinarians often do not provide the work schedule flexibility and benefits provided by larger private and corporate practices.
The question that comes up frequently deals with the future of private practices and corporate practices. How will pet insurance affect the level of patient care in the future? Will corporate practice eventually replace private practice as we know it today? Who will buy all the one and two person practices that are now in operation when the owners want to retire? Will there be a balance between corporate and private practice?