Eagle Post: Some thoughts on advancement of independent practice

Tom Donnelly writes on developments in the US veterinary industry.

While big businesses such as Banfield Pet Hospital and VCA (Veterinary Centers of America) — the two largest owners of veterinary hospitals in the world, both owned by Mars. Inc. — grow, a group of practitioners who value their autonomy have formed an organisation dedicated to the advancement of independent practice. It’s called the Independent Veterinary Practitioners Association (IVPA). The organisation debuted in February.

In addition to major chains, smaller consolidators are buying freestanding practices at a rapid rate, according to a report by Provident Healthcare Partners LLC, an investment bank. John Volk, a senior analyst with Brakke Consulting, estimates that 10 per cent of general companion animal practices are owned by 30 or so corporate chains and aggregators.

The prominence of corporate consolidators and chains has observers wondering whether the American Veterinary Medical Association can adequately represent independent practices, especially now that veterinarians employed by Banfield and the like are encouraged and financially supported to take leadership roles within organised veterinary medicine. During the AVMA Veterinary Leadership Conference in Chicago in February, attendees openly debated how the AVMA can best serve the two competing groups, which comprise the bulk of the national association’s 91,000-plus members. Propelling the talk was news that Banfield receives group discounts on dues for state veterinary medical associations. It and other large corporations soon might seek group rates on AVMA membership and professional liability insurance, officials with the AVMA House of Delegates reported. The news has some independent practitioners in a state of exasperation.

“More needs to be done to communicate with independent practitioners and advocate for them,” John Borzillo, one of the group’s founders and a dairy practitioner in Wisconsin, said. Considering that the world’s largest corporate chains are involved in AVMA politics, he pondered, “How can the AVMA say to consumers, ‘You should go to the independents rather than corporations?'” The IVPA would be better suited for that job, he said. Comprised of ideas and a website, IVPA has no services to offer — yet. Membership is free, for the time being. Top on the group’s agenda is attracting members as well as lobbying for and promoting the value of independent veterinary practice, both to consumers and lawmakers. It’s a job that Dr. Don Woodman, an IVPA co-founder who owns a practice in Safety Harbor, Florida, says is paramount to the survival of independent veterinarians. The profession, he says, is undergoing a “huge cultural shift,” one that has mom-and-pop practices struggling economically against the buying power of major corporations and “national corporate practices, don’t even appear so outwardly.” Woodman explained that some corporate chains present their practices as independent small businesses so as to appeal to a “buy local” trend that has consumers shopping in ways that boost their local economies. “When I came out of school in ’95, everybody said the sky was falling because Banfield was taking over. And then VCA came along, and their idea was to buy practices and brand them,” Woodman said. “But now we have corporations — NVA (National Veterinary Associates) is an example — that you don’t even see as a corporate brand, and that’s a more powerful approach.”

NVA has 424 locations throughout the United States, Canada and Australia, according to the company’s website. Twenty-nine are in Florida, Woodman’s home state. “Outwardly, they look like mom-and-pop veterinary practices; you can’t distinguish them from private practice,” Woodman said, referring to independent practices. “It’s like the farm-to-table or craft-beer movement. The social movement toward authenticity — that’s what they’re tapping into.”

NVA bills itself as a way for owners to sell easily, without having to trade the “legacy” of their practices for the look and feel of corporate sameness. “Many veterinarians envision selling their practice to a respected associate,” the NVA website advertises. “Someone who provides great care. Someone who is respected by staff. Someone who honors the culture. NVA can be that someone.” So might VetCor, which operates “a family of 254 exceptional veterinary hospitals across the United States,” according to its website. Like NVA, VetCor buys practices that maintain their local identities. The company tag line: “Helping practices thrive. Medical freedom. Local identity. Shared resources.”

While many veterinarians are comfortable with the concept of practice consolidation, they feel that posing as a local small business is underhand. None of VetCor’s hospitals bear the company’s name on signage. Their individual practice websites routinely list the practice’s “founding” veterinarian rather than its owner, VetCor. One veterinarian, Dr. John Daugherty of Poland Veterinary Centre near Youngstown, Ohio wrote in a Veterinary Information Network discussion that VetCor bought a third practice in his area. The only reason he knew about the first two buyouts was “because they approached me … and mentioned the others. The rep made a point of saying that they keep the corporate ownership quiet, and that they do not want clients to know about it.”

VetCor’s Diana Byrne, director of marketing and employee engagement, said keeping the practices they buy looking and running as though they’ve never been sold isn’t about duping the public; it’s about continuing the former practice owner’s legacy. She points out that many independently owned practices have changed hands several times but still carry the name of the founding veterinarian. The same is true for corporate consolidators. “When you change the name, you’re rebranding and becoming an unknown,” she said. “We’re not trying to be disingenuous. We don’t turn over the staff. We keep the seller on board. There’s no change in the medicine, or what they’re ordering or pricing or their services.” She added, “We’re buying practices that have reached a level of revenue and value that’s difficult for a private practitioner to purchase.”

It’s the same for other corporate consolidators, noted Volk, of Brakke Consulting. “Consolidators need to acquire large practices — three or more doctors — and half of the practices in the United States are still one- or two-doctor practices,” he said. Volk does not believe when independent practices will eventually be a minority, for several reasons.” A lot of veterinarians go into the profession because their vision is owning a practice, and that’s still a practical goal. They can get financing. Veterinarians are low-risk to lenders,” he said. Woodman wants to see IVPA evolve to help unite practice owners and potential buyers the old-fashioned way, which doesn’t involve a brokerage firm or major corporation. Consumers have choices for pet care — nonprofit, national corporate practice, independent and locally owned — and so should veterinarians who want to retire or buy a practice, he said.

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