There is a fish in the ocean called a Cleaner Wrasse, and it is trusted by numerous, amazing kinds of fish to remove disease causing organisms from them.

This cleaner fish does not want anything, it doesn’t hope for fish to get ill, and it doesn’t complicate the relationship. It’s simply “makes a living“ whenever a fish with a health problem shows up. That’s it. Not complicated.

Doctors on the other hand, are a little different.

It used to be that doctors were “individuals”in small towns with a reputation and a good name. Their kids went to school with other kids. They were accountable to the community. What they did reflected on them for better or worse.

Until in 1960, the Supreme Court ruled that corporations could own the doctors.

This broke that bond between the doctor, those things like ‘reputation’ and ‘accountability’ in the community, because the corporations were solely profit motivated.

Behaviors, marketing practices, standards of care, and the “requirements“ of customers who were about to receive care were suddenly determined by non-doctors with long-distance last names, and reputations, who could hide behind, (and blame the mercenary nature of their behavior on) the “shareholders“.
They say: “I personally would never do this, it is mercenary and extortionist, but “the shareholders“ demand a profit on their stock investments.“

That cop-out has been used since the advent of “corporate“ structure.

Some of us remember when Union Carbide destroyed the lives of tens of thousands of people in Bhopal, India.

The cost cutting and deferred maintenance that led to that disaster; while certainly they were decisions made by a couple of key people, that stained legacy does not follow their family-name and their kids, it ended with the corporation. Their individual unethical and even criminal decisions and poor choices no longer reflect on them morally, but they should.

So, where am I going with this?

Veterinary medicine has taken the same turn, because now, veterinarians are increasingly “employee“ and they get cornered by corporate practice to do things that they may or may not think are “in the best interest of the pet.“
Like mandatory bloodwork before they can attempt a surgery in a terminally ill patient. Two views on all radiology even when the penny is obviously in the stomach or the fracture is non-comminuted-transverse and you’re referring: STILL the extra $100 for the second view.
Essentially, the establishment of ridiculous “minimum database“ items that mandate more spending before an appropriate treatment can be instituted.

This experience that I had while practicing in corporate-medicine sums it up perfectly:

An owner might (did) call up and tell me that their cat had a tapeworm. There is a dewormer that controls *all* intestinal nematodes and cestodes. I could have given the cat that pill, and know “for a fact” that it no longer had an intestinal worm of any kind. That’s far more “certain” than any test!!

However, in that particular corporation, I was unable to even dispense that tablet until I had entered the #SKU for a complete physical exam, and a fecal analysis. Only then, did the dialog box for the tablet open up.

That client, unknowingly, ended up spending at least $75 more than they needed to, because someone in Arizona figured out a way to make veterinarians over-practice, and oversell.

I was ‘done’ with corporate veterinary medicine in less than a year. I’d seen enough.

Veterinary Medicine of the Future: 2029

In 2029 veterinary medicine will be very different than it is today. In some ways it will be better. In some ways it will be much worse. The “general practitioner” will be gone, so services will be concierge or a la carte from several sources as the market gets fragmented more and more.

1. To get your shots, (and I know you think I’m kidding) but you’ll be driving to the nearest Autozone parking lot, or Walmart.
2. Spay & Neuter: Cut rate spay neuter clinics
3. For a mildly sick dog, you will take him to Walgreen’s, or to Blue Pearl.
4. For emergencies, Blue Pearl again.
5. For sick dogs and very sick dogs, you’ll take him to Blue Pearl.

Fact is, Blue Pearl aka Mars Animal Health is going to dominate by 2029 and that’s a VERY bad thing, except they won’t be able to capture the vaccine market from Walmart and Autozone / Waffle House.

And they won’t be doing spays and neuters, either, because for that, you’ll have to drive to a bad part of town and have it done at a “Spay Neuter Clinic” by veterinarians that are, hopefully, licensed to practice in the United States WITHOUT supervision from a US Licensed vet. (Again, you think I’m exaggerating but it’s already happening in Marietta, Georgia.)

So long, family vet.

Within the next 5 to 10 years veterinary medicine will have changed drastically. Or maybe to some people, just a little bit.

By 2029 – A full 99% of veterinarians will be employees. Either as employees of a larger corporation such as Mars Animal Health, or employees in the actual clinics. Meaning, salary expectations for veterinarians will be $50,000-$100,000 less than if you went to school in the ’80s. The number and caliber of applicants to veterinary school will naturally decline in favor of more solvent careers, but that’s OK because most of these veterinarians will be going out into corporate jobs where decision-making isn’t really even in their wheelhouse anymore.

REASON: Corporate veterinary medicine will prevail by year 2029 according to experts, and in corporate veterinary medicine, the veterinarian simply checks off items on an exam, enters bloodwork values into a computer and get a rule out list that specifies what they are to test next. Their diagnostic algorithm is specified as a “minimum database” which excludes things like “instinct ” and valuable “experience“ leaving you in the hands of the corporation that actually programs the diagnostic and therapeutic algorithms that go in the computer.

I recall working for a veterinary corporation wherein I was not even able to choose the suture material I would use to close the skin. We couldn’t even enter a deworming into the computer until we had put in a complete office call at full price, plus a fecal exam. Even though dewormers exist that treat all intestinal parasites.

These veterinary corporations won’t be doing many surgeries, however; because at the same time as they are taking over the role of diagnostic-veterinarian, veterinary surgeries are going down the street to low-cost spay-neuter clinics as if pet overpopulation and roaming animals with a thing anymore. In some metropolitan areas rescue organizations are fighting over dogs that they can rescue. North Shore animal league in Long Island doesn’t have enough animals they fly them in from all over the country (Good on ’em!).

So your 2029 surgical options are likely to be limited to cut-rate employee veterinarians that earned their licenses in the Caribbean, India, can only practice with supervision* in the United States, and/or low-cost spay neuter clinics with substandard cleanliness and surgical gear.

*Tens of thousands of veterinarians from Eastern Bloc countries were out of work after the Berlin wall came down and can’t get licensed in the US. So they’ve come to the US and work as veterinary technicians, and they can perform veterinary surgeries AS LONG AS they’re supervised by a licensed veterinarian, AND the licensed veterinarian puts his or her license on the line for the performance of said surgeries. It’s happening in Marietta GA at low cost spay neuter clinics already.

Let’s say that you would “never use a low-cost spay neuter clinic“… Yes you will, if the more of the public puts the general practitioner out of business on these surgeries leaving mainly low cost spay neuter clinics LOL.

I’m not whining because I’m a one-person practice but in 1999 I was doing 10-12 spays or neuters per full business day and now I do one or two, in 2020. Again, I’ll be FINE. As a one-person practice, I’m payroll-lean. I don’t have 5 veterinarians on payroll leaning on counters waiting for clients.

To make matters worse, the vaccine healthcare discipline is going to stop happening in general practice offices, it’s already going down the street to Waffle House parking lots, real-estate offices (not-kidding)* and festival tents at Pep Boys.

*Proceeds benefit the veterinarian giving the shots. Go figure.

Card-table veterinarians under the auspices of companies like Shot vet, setting up weekend clinics with notoriously subpar recordkeeping, warm and expired vaccine, veterinarians that can’t hold a regular job, but at half the price of the regular veterinarian with a competent staff*, soon your best if not only option for vaccine is going to be in a parking lot.

*At walk-up shot clinics you hold your own animal and examinations are minimal.

Walmart and some of the other big shopping stores are opening minute clinics for veterinary services like lacerations and vomiting. Vaccinations and other veterinary essentials being performed by veterinary employees. You can bet these people really care about what they do on a Walmart salary. Giving shots but having to refer just about everything else. And again, in corporate veterinary medicine you basically do what corporate says, “thinking outside the box” could get the corporation sued, so it is frowned upon. I was literally told “not to do it at all, or check with me first!” by Charles Biersdorf at Petsmart.

If your experience or instincts say skip a step, or use something different, that leaves the corporation open for lawsuits and that is not happening. You will do as they say. I could not abide that and left corporate medicine after nine months there.

“Thinking outside the box” could get the corporation sued, so it is frowned upon. I was literally told “not to do it at all, or check with me first!” by Charles Biersdorf at Petsmart.

Diagnostics, are soon going to come at a very high price because the general practitioner will no longer be brought to bear on a vomiting dog, a dog with seizures, spinal problems or a dog with a significant laceration. Currently, corporations are advertising with items like “laser, CT scan, MRI imaging” not because these items are particularly useful from day-to-day, but they create the image of highly advanced technologies that could be brought to bear to save your pet.

Would you be more inclined to take your pet to a clinic that touts: “Now using the latest in magnetic resonance imaging MRI” or a clinic that says “We can make Xrays”     Seriously. It’s cool. But does it matter? 

So the general practitioner is naturally passed over for these more advanced diagnostics until too late, the client realizes that a $1800 test could have yielded the results the same as a $300 test. Why didn’t they tell you?

With a $100,000 machine to pay for, do you think that diagnostic is going to factor into “every possible case work-up”? You bet!