The Practice Success Prescription: Team-Based Veterinary Healthcare Delivery by Drs. Leak. Morris Humphries
Thomas E. Catanzaro, DVM, MHA, FACHE, DACHE
The recent Curriculum National Task Force efforts, a project that stemmed from the 1999 Mega Study introduced back in Chapter Three, have identified "well-evolved life skills", rather than science and technology, as the primary deciding factors for veterinary practice success. As a profession, we have often joked about the 4.0 GPA veterinary student going to work for the 2.5 GPA veterinary graduate, but reality is the basis of this humor. As an example of our own paradigms, the "in-bred" and self-effacing communication styles, we only need to read the executive summary of the 1999 "Mega Study" and then look at the subsequent "Compliance Study" (circa 2003).
In the Mega Study there was an executive review, which provided six major economic issue findings:
Demand: Real growth rate of five-point-one percent for expenditures on veterinary services through year 2015, with only two percent expected in total consumer percentages.
Supply: More veterinarians being produced than needed, the number of veterinarians will peak at about seventy-six thousand five hundred in 2017, as robust graduate production is slowing: twenty-six thousand in 1977 to sixty-three thousand seven hundred fifty-one in 1997, and over-supply will stabilize.
Gaps between supply and demand: Peak gap in 2008, then slow decline until balance achieved in 2014. Expect downward pressure on income per FTE during the over-supply period.
Price elasticity of demand: More providers in the market keep prices more sensitive to consumers' desire for lower cost, yet the nine important factors for clients selecting a veterinarian listed price in ninth place, as shown above.
Income: Higher fees have higher net (well, DUH!). Increased spending predictions will be offset by excess veterinarians, so income recovery is not likely until after 2014.
Forces impacting market for veterinary services:
Legal boundaries: Practice Act, licensing, veterinary extenders, legal substitutes, over-the-counter changes, etc. (Note: the study ignored what associations could do to change these limitations.)
Role of women in veterinary medicine: The gender shift of the profession. Women will be fifty percent by 2004, sixty-seven percent by 2015, and seventy-eight percent by 2017. They will work three to four hours less than men per week. (Note: the study ignored what "reasonable work hours" should be.) Women price lower than men. (Note: called weak evidence in study.) Gender wage gap in veterinary medicine less than in other healthcare fields, but widens with tenure. (Note: statistical sampling methodology not clearly explained on this set of issues.)
Student debt: Common in all graduate fields, more pronounced in healthcare delivery fields, but veterinary medicine salaries lower, so debt repayment more difficult. Statistically, ten percent of gross wage for veterinarians, eight-point-six percent of gross for dentists, and five-point-three percent for physicians.
Trade in animal food products: More export and less import was projected. (Note: BSE was not addressed.)
Pet health insurance: Predict higher potentials in this area than what is being captured at present.
Human-animal bond: People who are more attached to their animals will spend more. Those who understand the bond will be more successful in private practice.
Commitment to pets: There is little to no correlation between family income and commitment to the family pet.
Changes in pet preferences: While households with pets have increased by fifty-eight percent, so has the variety of type of pets.
Public perception of veterinarians: Pet owners rank veterinarians first among the healthcare professions for compassion, honesty, and trustworthiness; second in intelligence; and third in education and technical proficiency. Horse owners rated veterinarians first in all categories.
There was a lot of money spent on the Mega Study, and while it seemed a major piece of statistical work of over seven hundred pages, the general practitioner at large did not perceive anything new in the findings, except for some statistical falsehoods. For example, the study's economic glut of veterinarians, when there were virtually no veterinarians available for employment.
To a student of organization behavior, the first impression was that the six critical issues shared with the profession were "targets for blaming". Blaming is nothing more than abdication for accountability in resolution. The second impression to the savvy evaluator was that there was no assessment of the role of veterinary schools or professional associations in:
1. Creating the current problem.
2. Minimizing the trends.
3. Resolving the current challenges.
In the cases of veterinary pet insurance and the effects of human-animal bond, it was hard for anyone to "blame", so they remained positive attributes in the report.
As consultants, we have some basic tenets for success, and one of those states simply: "When you blame you abdicate accountability for resolution!" The Mega Study summary provided plenty of blame, but it also had some very interesting "client bonding" findings, which have been all but forgotten in the rush for the NCVEI dollar tracking.