Black suits, business meetings

When Big Business and Big Pharma moved in

Veterinarians, in general, are down-to-earth people. They love animals and are not afraid to get their hands dirty. They have scooped litterboxes, walked around their yards picking up dog poop, cleaned horse stalls, and milked cows. At least many veterinarians have done at least one or two of these things. Their general business attire can range from scrubs to a sports coat to Wrangler jeans and cowboy boots.

When I attended the world’s largest veterinary conference around 10 years ago, much to my amazement I saw men in black suits and women in suits and heels in small groups milling around the hotel lobbies and bars. I admit it had been a couple of years since I attended a conventional veterinary conference. I had been busy taking classes to obtain my veterinary acupuncture certification. But how could things change this fast?

Groups of men and women in black suits milling about in small groups. All I could think of was Big Pharma or corporate mafia. But maybe that was just my Gen X punk rocker bias raising its head, or so I hoped.

Then I began hearing of small veterinary practices selling out to Banfield and Veterinary Centers of America, 2 of the first corporations that began buying up independent practices. Within 5 years, there were numerous corporations making offers to practitioners and gobbling up the practices. The narrative became, how else were these veterinarians ever going to retire? Who else was going to buy their practices from them?

In reality, the profession of veterinary medicine had fallen prey to big business, and what easy prey it was. An industry that reached 99 billion dollars a year is not going to go unnoticed by global corporations. Pets have become our children, our therapists, our emotional supports and people will spend more money on them in many cases than on themselves.

Veterinarians are not business people. They did not get into the profession to become millionaires and put profit before patients. In fact, veterinarians are notoriously bad at business. The business training that we receive in veterinary school is often a one-time seminar, several hours long, talking about business insurance, leasehold facilities, hiring a team of professionals, ie an attorney, an accountant, to do the heavy lifting, and a few other basics.

Once we are in practice and develop close relationships with our clients, we notoriously either charge too little or give away too much, to help the family help the family dog.

So at the same time that American society was coming to terms with its broken human medical system and attempting to find a way out of that mess, that same broken system was weaseling its way into veterinary medicine. It was familiar, everyone knew how it worked, and it was so easy to replicate. It was too perfect and too easy.

The corporations buy up the veterinary practices. They make deals with the pharmaceutical companies to buy a certain amount of specific drugs and get a great price for said pharmaceuticals (more on that later, and the making of the Opioid Crisis in Veterinary Medicine). And we can’t forget about the pet insurance companies. In order to raise prices to cover corporate expenses, dividends, payouts etc. people need a way to be able to afford the more expensive care. Enter insurance companies, unregulated insurance companies. Pet parents buy policies and pay monthly fees. The insurance reimburses the pet parent, up to a specific amount per diagnosed illness.

We now have the complete triangle: corporate clinics - pharmaceutical companies - insurance companies, churning away to capture more money from concerned, loving pet parents.

Whoops! I forgot a couple of links in the chain: pet food companies take in a huge portion of the total profits of the pet industry. Pet food companies have researched and found ways over the years to turn cheap inexpensive ingredients, essentially industrial waste products, into pet food, or rather billions of dollars worth of pet food.

The side effect of feeding industrial waste products to our pets is increasing numbers of diseased animals. It all begins with inflammatory diseases, the “-itises”: otitis, gingivitis, gastritis, pancreatitis, arthritis, cystitis. Most pet parents will recognize one or a few of these disease processes.

If the “-itises” remain in the body for too long they progress into allergic conditions, autoimmune conditions and the big C word: cancer. Cancer rates in our dog and cat populations are exploding. 1 in 3 dogs will develop cancer, 1 out of 3. That’s another food and environmental-related discussion. (Please ban RoundUp!)

The other forgotten link is the diagnostic laboratories that run the tests to diagnose the conditions. Two big national laboratories bring in millions of dollars.

What better way to round out the picture than to own the food that makes the animal sick, own the clinics the sick patients are taken to for help, own the diagnostic labs that run the tests, and make big deals on the side with the pharmaceutical companies that make the drugs to treat the conditions.

Do we have all the bases covered?

One last thing: the veterinarians themselves. Veterinary medicine has become largely a female-dominant profession. There are approximately 68% female to 31% male veterinarians. Women veterinarians are actually discouraged from aiming for partnership levels, claiming they would be unable to be both a partner and have a family. Women actually make the perfect corporate worker bee. The corporations can pay them less, and work them harder as their expectations are already set lower in terms of pay, productivity and expectations.

https://www.vetspanel.com/women-in-veterinary-medicine-why-more-women-doesnt-equal-more-equality/

‘ “It’s the loss of the old school model of vet (typically man) buys practice, or buys in to practice partnership, practice grows, practice owner or partners take home good salary and then sell the business to fund retirement. This sale used to be to the new associate to allow them to grow their career. But now, corporate companies are always able to out-compete what associates could pay and so the model of starting out as an associate and becoming a practice owner has become almost obsolete as no one can afford to buy a practice.”

Finally, and most depressingly, the veterinary industry seems to add another industry datapoint to the theory that when an industry starts (for any reason) to become more female its perceived value, and therefore salary level, drops. This also works the other way round; as soon as computing became something done by men, rather than a menial job carried out most by women, salaries shot up.”

Veterinary schools have their role to play as well. The new corporate version of what it means to be a veterinarian must be trained and programmed. How the students are taught to work up cases must align with the computer programs used in the corporate clinics. Gone are the days of SOAP protocols, on to algorithms that lead one to the appropriate pharmaceutical. General practitioners become just a means for a referral to a specialist, and the price goes up as does the profit margin. Big pharma funds the research and is on the editorial boards of the scientific and medical journals as well, no loose ends allowed.

So what is the endpoint, or middle point, in this system that has encroached its way into veterinary medicine?

The subjective quality of medicine practiced, including the all-important bedside manner has decreased. Veterinarians are scheduled by corporate managers who are looking out for the bottom line: profit. Fifteen-minute appointments, very little time for education, explanation, and informing the pet parent. This places an undo amount of stress on the veterinarian, especially early in their career, and creates angry, upset pet parents, creating more stress and unhappy clients.

And when the drugs that are on the shelf are prescribed and they don’t solve the problem, the client is more upset, and the veterinarian does not have any other options. On the back end, the veterinarian is working based on commission and has their high debt load looming over their heads.

It is a perfect storm, wherein the clients no longer trust the veterinarians, who are treating based on algorithms and treatment protocols written by Big Pharma. The veterinarians are treated no better than salaried employees with no hope of practice ownership or setting policies. The insurance companies only pay up to a certain amount and then drop patients at their most vulnerable, during their geriatric years. And the corporations reap the profits from the pet parent and out of the veterinarian’s pockets, “they are just women, after all, women who love animals, they will work for less”.

As I reach the last stretch of my career, I witness more of my colleagues making deals with corporations. It is seen as the only way out, and when the money is offered, it is impossible to turn down. There is a bittersweet sadness involved. Most, if not all of these practices were built up by these doctors, built on the relationships they formed with members of their community. We often see multiple generations of the same family and their pets. They are small businesses built on sweat equity, honesty, compassion, and their love of the animals, and the belief in the human-animal bond.

I may be jaded, but I do not see corporations capable of nurturing that human-animal bond. That comes from the heart, not a business model. And just as corporatization is taking hold, the relationships are rapidly falling apart between clients and veterinarians.

Clients don’t trust veterinarians.

Veterinary medicine has become the highest-risk profession for suicide.

And the animals are becoming lost between the cracks.

Need I say more?

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