Veterinary Colleges: change is needed!!

In my last post I touched on many similarities between NA equine vets and our counterparts in Europe. I omitted one particular topic because it deserves a post of it’s own: vet colleges are now trying to compete with private practitioner. We were attending a presentation from the dean of the School of Veterinary Medicine in Utrecht, The Netherlands. His talk was on the changes he is instituting in his college to help increase the caseload. I realized that he was trying to do with his institution is what the deans of so many vet schools in North America have been doing; building a state of the art facility in hopes that it’s mere presence will flood the teaching hospital with cases. Most of us are aware that vet schools are facing significantly decreased caseloads due to the presence of private practices that can offer faster and more efficient appointments, better client service, and continuity of patient care, among many reasons. The vet school business model is broken, and instead of examining why it is broken and developing realistic strategies to maintain the quality of the education they offer, institutions think that building bigger state-of-the-art teaching hospitals or buying up local private practices will regain the lost caseload. I knew this had been going on in North America but I was surprised that the same scenario is playing out throughout Europe.

In discussions later on, the group of private practitioners at the conference had the same litany of concerns. Tax money is being used to compete against private practitioners. The culture of vet colleges is such that they can never offer great service and the clients are choosing to use private clinics where these needs are begin met. Frustration over the shrinking caseload has led to clinicians openly criticizing private practitioners in front of students and clients. When local vets have approached the state or provincial college about working together, their concerns are ignored. I will give credit to the dean of the college in Utrecht on this last point. He seemed genuinely concerned about finding a relationship with local vets that was mutually beneficial.

Is there a solution to this problem? As private practitioners we can ignore it. It can be a competitive advantage to be located near a vet college, since the level of service there is usually so poor that it is easy to look good next to them. That is a cynical and myopic view though. We need well-trained future vets that have an appreciation of private practice, and not the book smart but clinically naïve graduates with a suspicious attitude of private practice that many of us are encountering now.

What is the mandate of most vet colleges? Education? Of course. Research? Absolutely. Operating a competitive veterinary hospital? Not so sure about the last one. Can clinical education for students be contracted out to private practitioners who meet the standards of the teaching institutions? This is being done at the newer vet colleges accredited in North America and it can certainly be adapted to the older schools as well. The students would get a structured clinical education in their junior and/or senior years that would offer varied and practical experiences, the money losing expense of a vet hospital would be eliminated, and there would be more collegiality between the schools and private practitioners. Programs for internships and residencies could also fit in this new paradigm. Vet schools will argue that there would be a lack of consistency in the clinical education with this model. Can they honestly say this consistency exists now? We have all experienced the frustration of being taught by a tenured professor who obviously hates their job or is so far removed from what is going outside of their field of research that they become a liability to patient care let alone the education of a student. At our local vet college many female students interested in large animal practice have been dismayed to encounter openly misogynist senior clinicians who belittle their desire to work in this field. I am sure that with a little effort, minimum standards for participating private vet clinics could be implemented. What is in this for the private practitioner? While the arrangement is not for everyone there are numerous potential benefits. They would be paid to host the students and they would have a ready pipeline for new associates. The students would be bring with them current knowledge on a variety of subjects that would be beneficial to seasoned practitioners in the field.

Something has to change within the vet colleges themselves and also in their relationships with private practitioners. My solution is not for everyone but I would love to hear thoughts from other people. Lets see if we can get a dialogue going and hopefully some ideas can come out of it that might foster a needed change.

If you are receiving this blog by email click on the title of the blog. It will bring you to the web page. At the bottom of the post will be a link called “comments” where you can post your comments.

109 replies
  1. Joop Loomans PhD, DVM
    Joop Loomans PhD, DVM says:

    As equine veterinarian you “get the customers you deserve”. This is what I tell students when I educate them on equine business management and it’s a statement that I really believe in. It refers to the colour theory of Léon de Caluwé on change management and is also related to internal branding. There are many different kinds of equine customers; those who find it important their horse is treated by a well known and respected vet, those who think it’s important to have vet a close personal relation with their vet, others only think about value for money or just want the cheapest and again others feel safe in a scientific and learning environment with their horses and those who go for vets who always have the newest/fancy “experimental” treatments available. To make it even more difficult to comprehend, it may even differ per case. Therefore I don’t believe equine teaching hospitals and private practices are really competitors. The equine industry needs the total spectrum of veterinary care.
    At Utrecht University we have a long tradition of a university ambulatory clinic in the vicinity of the faculty clinic in a radius of about 25 kilometres around Utrecht. This goes back to the beginning of the twentieth century and has been in equilibrium with the growing numbers of private practices around Utrecht (by veterinarians the university educated!). Nowadays we live in perfect harmony with these practices and we all “get the customers we deserve”. Our customers are those who love to know more about their horses and their health, they don’t mind if a student is working with their horse as long as they get “added value” by learning with the students and of course the horse isn’t suffering. They don’t mind if the consultation and treatment of their horse takes longer, as long as it is not an emergency situation and they will pay a normal fee for these services (we calculate the time an experienced vet would need for a particular consultation and treatment). Therefore we do not compete on price and use the money we get for educating students to pay for the extra time we spend while educating. We find this a very good and simple way of pricing and we even find practice around us being cheaper than we are.
    The situation might be a little more complicated for referral hospitals since, as Mike Pownall stated, Universities are often able to build larger facilities using public money. I remember Mike walking through our premises, wondering how much this would have cost (and how much the tax payer had invested). One should however bear in mind that teaching in a clinical setting with real patients requires a safe environment for patients, clients, students and teachers especially when the university education philosophy is to have an increased responsibility for students in patient care during their curriculum. We want students to learn by doing in a safe environment, starting in our clinic with our own horses, but this is quickly extended to real patient care in our hospital (both intra and extra mural). Later, in the final year (sixth year) students have eight weeks of clinical work in one of the five private equine practices in the Netherlands we work with.
    Teaching veterinary medicine, educating young adults to become an equine veterinarian is a beautiful job. Together with the veterinary profession we have set standards by writing “Programme Outcomes of the Veterinary Curriculum”. This ensures the involvement of the veterinary profession in the education and the educational goals and makes us all responsible for the future of our profession. Therefore we should not loose ourselves in discussions about fair or unfair competition but join forces and work on a sustainable future of both your practices and our teaching hospitals.

    Joop Loomans, PhD, DVM, Faculty of Veterinary Medicine, Department of Equine Health, Utrecht University, the Netherlands.

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  2. Mike
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    Joop,

    Thank you for your eloquent comments. I was very impressed with the colleagues you speak about and how they enjoyed working with your university. Unfortunately, this is a rare occurrence in North America. As I commented to your dean hopefully your institution can take the lead world wide in how vet colleges can work with private practitioners.
    See you next week in Wisconsin.

    Mike

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