Team Culture

Are we seeing an increase in veterinary consolidation? In this episode of the Cone of Shame Veterinary Podcast, Dr. Andy Roark is joined by Ryan Leech, host of The Birdbath podcast to discuss the ongoing trend of consolidation in the veterinary industry, where corporate groups and private equity firms are purchasing veterinary practices, leading to a transformed industry landscape. Ryan shares insights into the slowing and recent rejuvenation of practice acquisitions, and the implications for practice owners, veterinarians, and staff. They also dive into the economic pressures, such as rising wages, and how these financial trends may impact the future of independent practices and corporate-owned hospitals. This is a must-listen for anyone interested in the big-picture changes happening in veterinary medicine and what it means for veterinary professionals.

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Ryan Leech on LinkedIn: https://www.linkedin.com/in/leechryan/

The Birdbath Podcast: https://podcasts.apple.com/us/podcast/the-bird-bath/id1697270947

Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/

Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

Ryan Leech is an experienced leader with a history of growing businesses through highly scalable sales models. With a background that spans multiple industries, Ryan led sales for startups that raised over $100MM in funding and ran his own sales consulting firm. In his role at Digitail, he is responsible for overseeing collaborations and integrations with industry leaders and innovators to drive digital transformation in veterinary medicine. In addition to his professional experience as Director of Business Development at Galaxy Vets and Hippo Manager Software, Ryan is also the host of “The Bird Bath” podcast.

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome everybody to the Cone of Shame Veterinary Podcast. I am your host. Dr. Andy Roark guys. I got to go in for you today I am here with Ryan Leech he is the host of the podcast The Birdbath. He does a podcast all about the like plate tectonic level movements of the vet industry So he talks a lot about earnings in the big pharma companies. He talks a lot about consolidation where groups of practices buy other groups of practices or who gets paid big venture capital investments.

I just think that stuff is interesting. I don’t track it like Ryan does, but he, that’s his jam. He’s all about where is the money going into our profession? Where is it coming from? I hate to say it, but boy, you can figure out a lot about what’s going on in our profession by looking at where the money comes from.

And so, anyway, that’s his jam. I wanted to talk to him today about what’s going on as far as consolidation among practice groups. We see groups of practices buying other groups of practices. It’s slowed down. I it is picking back up and has continued to pick back up. I talked to him about if is that true?

Where does that go? Does he see it going on? Are we looking at the risk at the economy and thinking maybe there’s a recession. This is going to change. He has thoughts on all of these again, and we’re kind of gazing into the crystal ball here. There’s a very interesting conversation about big level high level. What is going on in our profession and what is it going to look like in the coming years?

So Ryan’s got some good ideas. Let’s get into this episode 

Kelsey Beth Carpenter: This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark. 

Dr. Andy Roark: Welcome to the podcast, Ryan Leech. Thanks for being here, my friend.

Ryan Leech: Thanks for having me back. I always enjoy listening and honestly, if you know me, I enjoy participating more than listening.

Dr. Andy Roark: You’re like me, like, I like to be an active participant in my conversations.

Ryan Leech: I like to talk about it not just listen to it. So thanks for having me. I’m excited for what we’re going to talk about today. I know you’re, you’re pulling, you brought me in and I’m ready.

And, but I told you not to prep me on 

Dr. Andy Roark: anything.

That’s right,

Ryan Leech: That way we can a raw and fun conversation.

Dr. Andy Roark: That’s good cause I’ve got, I’ve got some stuff I’m working on. Okay, for those who do not know you, you are the host of Ryan Leech probably the podcast I would consider to be the most required listening in Vet Medicine. Aside from my own, of course, but, but other than mine, other than mine, no in all serious.

Ryan Leech: The number two podcast on this 

Dr. Andy Roark: show.

That’s okay, by in my estimation, you’re probably the number two podcast host in on the industry. No. You are the host of The Birdbath, which is which is this really great, it’s very short, it’s weekly. It is a recap of what is happening at the industry level of vet medicine. So you talk a lot about the earnings reports of different like pharma companies.

You talk about consolidation. You talk about what practice groups have bought other groups and what they’re doing. And that may sound ridiculously boring to people who are in the trenches of that medicine. I get it. However, It is basically a report of how the landscape that we live on is changing and fluctuating.

So I really encourage people if you haven’t given the podcast a try you should just listen to it. It’s something that’s really good to just keep checking in on because the things that Ryan talks about are the things that come to fruition and affect our lives in the practices A year down the line.

And so anyway,

Ryan Leech: yeah, and the thing though about the show that I, cause yes, it’s, if you’re not in the vet industry, you shouldn’t listen. You’ll be so bored unless you’re wanting to invest in it or do something.

Dr. Andy Roark: I tried to get my wife to listen one time in the car and she was like, I’m not, we’re not doing this. 

Ryan Leech: Yeah, my wife doesn’t even listen to it. You’d think she would, but yeah, the thing is, I want it to be a kennel attendant driving into their first day of work and I want Kristen Peck at Zoetis to both be able to listen and leave with something that they didn’t know was happening in the space.

So it’s supposed to be extremely digestible. It’s less than 15 minutes every single week. We just had our one year anniversary with it. So yeah, I’m really, really happy with the show.

Dr. Andy Roark: You do a really good job of taking this stuff. And it’s, it’s, it is very accessible. Like just between, you was gonna say, just between you and me, just between you and me and 

Ryan Leech: everyone listening 

Dr. Andy Roark: I, I think you do a good job of saying, this is what this means, or this is why this result could be important going forward.

And I just, I think you do that really well. You are also a a consultant in the veterinary industry. You work with, with. companies that are interested in entering the Vetspace or working in this Vetspace and want to grow.

Ryan Leech: Yeah. All the things I talked about on the birdbath are kind of my preppers in my mind of how to help businesses grow in the vet space or enter the U S market or, or things like that.

Dr. Andy Roark: So that’s great and it brings me to kind of what I wanted to ambush you with today. So it’s, it’s this, I wrote a little newsletter, so I write newsletters like every week and I just often kind of write about what I’m thinking about and things that people say to me. And so, so I wrote recently this little newsletter and it called it that eventually the numbers have to work.

And the basic premise, Ryan, is, is I’ve talked to some, some veterinary students who are getting close to graduation, and they were talking about signing bonuses and salaries for some of their for some of their graduating vet students. And I’m going, oh my god, you gotta be kidding me. And again, no shade on the vet students, but it’s just, wow.

And then I talked to some of my friends or people who are at Uncharted, and they have their own hospitals their private practice owners, and they’re like, I cannot afford to hire a new graduate at the rates that they’re, they’re getting from other places. And it’s just really interesting when I hear these sort of concerns from practice owners and I hear these things from vets that are looking at these contracts and things and I go, I just want to lean in and say, you know, guys, eventually the numbers have to work.

Like at some point, no one’s doing this as a charity. Like this is all investment and ultimately the numbers have to work. And so I’ve been looking at that and thinking about that and I think it’s sort of a testament to how our profession has been stretched by private equity money coming in, by investment coming in, by corporate consolidation, where people are willing to do things to acquire practices that don’t make sense in the short term and that most of us could never afford to do.

But the idea is down the road this will make sense. And so, I’m really interested in talking with you today a little bit about how the numbers eventually make sense. You’ve been covering a lot in terms of consolidation within our industry. The last couple of months it seems like there has just really been a huge amount of movement as far as companies that own vet practices.

Buying other companies that own vet practices and so I wanted to come in and get an overview sort of like a every week you’re doing a report from the week I would really like to get sort of a review discussion from you of what do you see going on over the last six twelve months as far as corporate consolidation and then I want to get into what you think that looks like and what is that?

Going to mean going forward. So let me just sort of pause here and say am I capturing this correctly? Do you agree that there seems to be increasing momentum in terms of consolidation in our industry?

Ryan Leech: Without a doubt, there is definitely a rejuvenation of the veterinary consolidation that’s happening. There was a, about a 18 month sort of slowdown that we saw in the previous 18 months or 2023 part of 2022. It, it slowed down a lot. And there’s a ton of economic factors that, that play into that. But the thing is it has shifted back now.

People are acquiring practices. I would say. Just roughly estimating in the last six months in just the U S alone, there’ve been two to 4 billion worth of consolidation and investment in vet practices. So it is definitely growing and taking off. There’s a massive deal that’s on the horizon that depending on when this comes out, people will either know about it or they’ll have heard rumors about it.

But yeah there’s a lot going on. There’s a lot going on. It’s going to continue to happen. We’ve got just the shrinking of the number of players that are owning the practices is happening as well. So it’s big. One thing I will say though, that I think was interesting when you’re saying the numbers need to make sense, that is kind of what happened 18 months ago.

And for the past 18 months or the past 18 months of slowdown was the numbers didn’t make 

Dr. Andy Roark: sense.

Right.

Ryan Leech: So you had groups that were acquiring practices where the numbers didn’t make sense and they were playing hot potato basically with these practices. And they were just saying, yeah, someone else will take, someone else will take it, someone else will take it.

And they weren’t making these improvements within the businesses. And eventually when the money’s slowed down, they were caught and kept holding the bag of all these practices where they had never intended to actually run them or improve them or perform the practices. And now the numbers didn’t make sense.

Which is now causing a bit of a paradigm shift where people are needing to do things that improve the financials of the businesses that they own.

Dr. Andy Roark: Do you think that that’s an accurate metaphor? So the hot potato, I want to go back to that. So what you’re saying is, there were players, and there were definitely players, who had no intention of actually running the hospitals they were buying. They were buying them, they were rolling them together, and the whole plan was, we’re going to sell this to somebody else as a bigger bundle, and we’re going to get a bigger multiple, because instead of buying, I don’t know, 10 practices, they’re buying a hundred practices, and we’re going to, we’re going to jack the multiple up, and we’re going to get out of here.

Having never actually, quote unquote, run these vet hospitals. And I could see that, and you would see some of the groups, and you thought these people clearly don’t have any real intention of wading into the operation side. And then It seems like the buying frenzy just sort of stopped, and the people at the top who were supposed to buy up everybody else, they stopped buying, and the people under them stopped buying, and the whole thing kind of backed down.

And then, you have some very responsible, very smart people who are holding practices and running them well. But you also had some people who were like, Oh crap, I thought I’d be out of this deal in six more months. And now it looks like I’m in the business of running a hundred vet hospitals or 25 vet hospitals or whatever.

And so is that sort of the hot potato metaphor

Ryan Leech: That’s the hot potato. Yeah. Because, I played in that world with Galaxy Vets that I was on the founding team of. And I was pitching to practices that wanted to sell practices against a lot of those. And the first question that a lot of people would say is what are you going to change?

And there’s an entire world of veterinary consolidators where their motto was, we’re not going to touch anything. And in a lot of them, they never did. You never saw them. The paychecks just changed names on them. Maybe they had a new bookkeeping system in the backend to be able to consolidate the numbers, but they didn’t do anything.

And that was what the seller in a lot of situations wanted. They wanted to be able to liquidate their sale of the practice. But the problem came when that hot potato, when you were the one caught holding it and you had to start operating the practice and then you realized, well, you can’t improve a business without making 

changes,

Dr. Andy Roark: Yes 

Ryan Leech: and so now they’re having to say Yeah, we’re going to make a few changes here they’re like, Whoa, I know that I want to keep running my business. Exactly how it was. And the difficulty there is it’s not your business anymore. It’s the group’s business. And whether they said they wouldn’t change anything or they said they would, ultimately it comes down to whatever they want to do.

It’s business too. 

Dr. Andy Roark: Eventually the numbers have to make sense, right? There’s no world where they can buy your practice, pay way more than it would be traditionally worth, and then not change anything, and everybody’s okay with, like that’s, it’s just, It’s not going to happen there. If they’re going to pay a lot, they’re going to try to increase efficiency and do things to make that practice justify what they paid for.

And so it’s that warning advice that I’ve been kind of leaning into is, if it looks too good to be true, it probably is. And ultimately, the numbers have to make sense. And so I do feel like days of getting bought and no one touching anything, they feel like they’re largely over to me. Unless you do have a corporate group that is serious about wanting individual practices to control their own culture. I mean, and at this point, you can tell that they’re not screwing around.

They will have made some changes and stuff, but there are some people who they were serious about it from the beginning, and they have, they have put their money where their mouth is, and I don’t want to, want to badmouth those groups, but that was not what most people were doing when they were saying, we won’t change anything.

Ryan Leech: I believe and I’ve said it and I’m happy to say it again publicly as many times as possible. I think that consolidation can be a greater good for the industry as a whole. When done in its most altruistic and true fashion, I do think that consolidation can help the veterinary industry.

It allows people that didn’t want to own a practice to liquidate their largest asset and continue practicing medicine and focus on that. Now there’s a mountain of things that can be terrible about consolidation and it wasn’t unique to the veterinary space. It’s uh, if you have a favorite restaurant that you started seeing a bunch of them popping up all over and they turned into a chain and then the quality of the food went down.

It’s usually interesting to Google the name of the restaurant and then type the word investor and you’ll find that they had some outside investor that didn’t have any history in that space and just poured money in and they lost what really made it there, but think the really interesting practices that don’t need things changed what you almost find there is that the owners of those practices either aren’t looking to sell because they’re bringing in enough profit and enough revenue to be able to sustain a very healthy business without having a boss, or they’re actually the ones that are being approached by groups or private equity companies that are saying, Hey, can you replicate what you did here?

And they’re actually the ones creating these new brands DeNovo or fresh built out strategies that are replicating their formula across the industry.

Dr. Andy Roark: I’ve heard it said that what sort of happened in medicine as far as consolidation has been seen again and again in other industries, and it’s fairly predictable cycle, as the way it was put to me is. We have these periods of consolidation, and they start out, and there’s a lot of players, and everyone’s grabbing at practices.

And ultimately, the prediction that I heard was we were going to end up with about seven, seven significant players, something like that. Do you think that we’re tacking towards that? Yeah.

Ryan Leech: Definitely. I like to look at the European market as a precursor to what the US market is doing on quite a few things in the vet space. It’s interesting if you look at where the UK was eight years ago and where we are today, they’re very similar worlds. I was predicting this on pet insurance.

I don’t know if it’s going to happen. I had some cool conversations with people around the actual world. legality differences between the two, but in the consolidation market, the same thing happened in the UK. They had dozens of smaller players acquiring practices. And then that partners came through there.

IVC Evidencia and Mars came in, acquired much of those practices. CVS group, which is massive in Europe as well as Swedish family that I’m completely forgetting the name. But. They probably own a lot of things and they, those just continue to consolidate those. So there’s about five to seven major players in the UK market.

And we’re now actually starting to see a few of those make investments first in Canada, which is pretty common that we see because the U S market is, it’s tough. It’s a very tough place to survive and be. But a lot of companies that are coming from overseas move to Canada and start that as their North American footprint.

And then we start to see them making some investments. So we saw this with Peloton, which recently made a, an investment in Lakefield group. They own a group of practices called P3 in Canada, and they just made this investment in Lakefield, which is a very well respected family run business by a Canadian family as well.

But they have a U S footprint. And so we’re starting to see that. trickle through of the border there. And I think we’ll continue to see that.

Dr. Andy Roark: So where does this ultimately go for people on the ground, Ryan? So is this going to are we getting near the end of the period of sort of radical change in a lot of practices? Are we, are we going to be stable in about five years and you’ll be in the program that you’re going to be? Or do you think things are going to continue to shift as far as new ownership, new way of doing things?

Get ready for more change. 

Ryan Leech: We’re still well below a 50 percent threshold of consolidated practices. The UK is 70 to 80 percent consolidated. So if you take what I just said, you should expect to continue to see independent practices being acquired and rolled up. I do think that one of the main things that comes by finding operational improvement in practices is one, technology is one of the quick ways that a lot of people look at that.

I come from a PIMS background in a lot of worlds. I think that you could start to see more of the unification of a practice management system across groups. So I guess one word of advice, if you’re in a corporately owned practice. And anyone says, hey, we’re thinking about doing this. If you want your voice heard, raise your hand and be the one that offers debate, a test them or check them out or do the demos.

Because I do know that these larger groups in a lot of situations don’t have as many boots on the ground experience, and they will really want to hear from the people in the clinics that are excited about embracing the change. So if your practice is sold and it’s owned by a large group. You’re not going to stop the wave of change, but you can probably direct the flow to places where you feel like it’s going to do the things that got you excited about practicing veterinary medicine.

Dr. Andy Roark: I do like that, I think a lot of times if we dig in our heels we just get plowed over

Ryan Leech: And then you get this the thing that happens then is we begin this continuous conversation where people say, I’ll never work at a corporately owned clinic. They don’t ever listen. And it’s like, well, did you also, was it a collaboration or was it a line in the sand that either side put? I think there’s great employers that are corporate groups and there’s great employers that are independent groups and the flip side for both.

Dr. Andy Roark: I’m seeing this trend of consolidation and practice groups buying other practice groups. And, at the same time, I’m starting to hear more and more grumblings about uncertainty around the economy. About I’m hearing people sort of start to talk about a recession. There’s definitely been more guarding of budgets on the industry side, things like that, that are starting to shape up.

How do those two forces interact, Ryan? Are we looking at a pause in consolidation, do you think? Do you think that corporate consolidation is going to continue on at this sort of this rate unaffected in the short term? What are your, what is your sort of feeling there?

Ryan Leech: first off, if I put a big asterisk on my face, I’m not an economist in any way. I read and listen to a lot of it, but One thing that, you know, if you look at, like, I’m not going to say we’re gonna have a Great Depression, right? But who left the Great Depression in the best system? Like, who was in the best place at the end of the Great Depression?

Were the people that had the most money at the beginning of the Great Depression.

And if you look at the contraction of that distribution of wealth and how that affects the recession, you’re not going to bankrupt a private equity group unless you do something like a GameStop did with Citadel. If you haven’t heard that whole dumb money story that’s the only way these companies ultimately do get taken down, but you’re not going to bankrupt one of these companies by them not being successful with a hundred veterinary practices that they bought.

So I think there, they have the deep enough pockets to wait out things that what you might see then is. Dr. Jones, who owns a practice and was thinking of retirement, but the value of their practice has been falling over the last 18 months or 24 months. And they’re going, well, you know, I still want to retire.

Okay. Well, maybe I’ll sell it for less than I would have, or what I thought it was going to. But so now the people that had the more money have the money and they can still afford to pay somebody that wants to find liquidity. So I don’t think it’s going to slow down. Yeah,

Dr. Andy Roark: Do think, you know ongoing consolidation, we’ve seen veterinary salaries go up, and I think that’s probably partly, partly due to the pandemic. supply and demand. It’s probably more than partly supply and demand. It’s, it’s a big piece of it. It’s hard to get veterinarians. Do you see those types of impacts trickling down to the support staff?

Whenever we start to talk about the numbers have to work, the comment section fills up with technicians saying, I can’t, I need to make more money. I should have a living wage. And I think that there’s truth to that. I’m not, I’m not yeah, exactly. I’m not downplaying that at all. Is there any clarity as far as when we’re looking at what’s happening at the industry level that would say it’s likely or this is going to continue to be a point of we’re trying to maximize shareholder value.

And so it’s going to be hard to see an increase in in salaries for, for staff. Is, I don’t know if there’s any ideas there.

Ryan Leech: There. Yeah. I mean, there’s definitely some ideas and there’s some trends that are happening. I think one is that we saw and we continue to see the prices of veterinary services increase. There’s two sides to that. I, from looking at financials of a lot of practices, there are a lot of practices that I think were acquired because they were seen as places where the prices weren’t increased.

There were, I think everyone knows a vet practice that they could walk into and see something on the shelf that’s being sold for less than what they bought it for because they haven’t updated their system.

Dr. Andy Roark: Right.

Ryan Leech: And as a private equity group, if you look at that, you go, all I have to do is start charging at least what we’re paying for it and I can make more profit.

But it’s not rocket science to them. So I think you see that. I do believe, though, that we are seeing a continued Increase in the demand for proper technician utilization. And I think that we might begin to continue to see that as newer veterinarians graduate. I know that there’s obviously that there’s always been the doctor versus technician divide in some ways.

And not to say it’s, acrimonious or evil in any way. There’s just always been sort of the, these are doctor roles, these are technician roles, the two shall not meet. But I do think that a younger generation is less rigid in their beliefs of hierarchy within spaces. It’s a generation of veterinarians that are coming out that someone probably called their elementary school teachers by their first name because that was expected of them.

And so when you have someone like that coming out, they’re probably not walking into a clinic with the technician that’s been there for 20 years and saying, I’m the doctor. You do what I say.

Dr. Andy Roark: Right.

Ryan Leech: They’re saying, Hey, Amy, what’s going on? And hey, this is what we do. Okay, cool. Oh, that’s so helpful. And then I also think that there’s an ability and an opportunity through consolidation for technicians to be able to improve and increase their skill set, which is much easier for a business to stomach as a reason to give someone more money than if we just say, I’ve been doing this for a long time.

The business is doing well. Give me more of this

Dr. Andy Roark: Yes.

Yeah, think that’s the difference there.

I think, I think you’re right. I think it’s I think that’s the key. I am very optimistic about technicians in the future and support staff in the future. I think that they are going to continue to make more money and I think that’s going to go hand in hand with them being better utilized and having more responsibilities and things like that.

I don’t think the, hey, we’re just going to ratchet salaries up. I just, I don’t think that’s going to happen. Not even that it’s not justified. It’s just, I don’t see it. I don’t see it happening. But I do think there’s opportunities. I think that there are things. I’m with you in that. I am an optimist.

I want to believe that consolidation can bring around good things. And I certainly can. I hope it will. But there, there are paths. With consolidation with bigger organizations where care stays affordable to pet owners, support staff get to do more things, get to earn better salaries, and then veterinarians get to stay engaged and be the center of the healthcare experience for pets and pet owners.

And so I, I think that is absolutely possible. I hope that veterinarians get excited and engaged and pushed to make that happen. Back to the earlier discussion we were having about digging your heels in. I think that if you do dig your heels in and you say, I don’t want to play with these companies. I don’t want to, I don’t want to play with this hospital group.

I don’t think they care what you want. And I think you’re going to get squished. I think the best thing you can do is jump in and say, how can I participate? Where can I land insight? What can I pilot here and give you feedback on that? I think that’s, I think that’s the path.

Ryan Leech: that’s part of why I do my podcast too, right? You, if you have the knowledge that the corporate group is looking at as well, and you can find an understanding of, wow, my parent company just brought in you know, 300 million in growth equity investment. And then you go to them and say, Hey, I know you want to grow these businesses.

Can we grow our revenue within our practice by looking at these three other businesses that I heard about? That’s kind of why, one of the reasons my sister in law’s a vet. And at her graduation, one of her co or colleagues or fellow students was telling me about the practice they worked at.

And they said, well, it’s not owned by a corporate group, but they manage it. And I said, that’s not how that works.

Dr. Andy Roark: Yeah.

Ryan Leech: And we went through and she was like, no, no, no. And I said, do you have a pay stub? And she said, yeah, I have one on my phone and pulled up the name of the company was there. I said, that’s who owns your practice.

The former owner still works there, but they don’t own it. So understanding what that means and who, if you want to ask a question or, or reach out to, or, make sure you have health insurance. There’s things that you can demand from a much larger company that they can afford as well.

Like you said, the money has to make sense. They have more of it, they can afford it, but it has to make sense as a reason to give it out.

Dr. Andy Roark: Ryan, thanks so much for being here and talking through this with me. Where can people find you online?

Ryan Leech: Yeah, so I have a couple of places you can find me online. You can always find me on LinkedIn, every social media. Plus I’ve got the birdbath. io. That’s where you can find all of the latest episodes of the podcast. And I also have first100. io. But anywhere you want to reach out to me, I’m not hard to find.

And it’s L E E C H. Put that in. There’s a professional BMX biker, but he’s a different guy than me.

Dr. Andy Roark: Sounds good. Ryan, thanks for being here. Guys, thanks for tuning in and listening. Take care of yourselves, everybody. I’ll see you later.

Ryan Leech: Thanks, Andy.

Dr. Andy Roark: And that’s it. That’s what I got for you guys. I hope you enjoyed it. I hope you got a ton out of it. Thanks to Ryan for being here. Thanks to you for being here. If you enjoyed the episode, leave me an honest review wherever you get your podcasts.

This is how people find us and it just means a lot to me. Anyway, gang, take care of yourselves. Be well. I’ll talk to you later.

Eric Garcia joins us to discuss staffing and technology efficiency versus the need for hiring in veterinary practices. In this week’s episode of the Cone of Shame Podcast, Dr. Andy Roark and Eric Garcia explore whether practices are truly understaffed or if the perceived need to hire more personnel is a response to inefficiency. The conversation dives into key performance indicators that suggest many practices might benefit more from enhancing operational efficiency rather than expanding their teams. They also touch on the role of technology in improving practice management through the use of automatic booking and AI record keeping. Let’s get into this episode!

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Eric D. Garcia: https://ericgarciafl.com/

Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/

Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: drandyroark.com/shop

All Links: linktr.ee/DrAndyRoark

ABOUT OUR GUEST

When it comes to helping veterinary practices streamline their technology and attract and retain clients, Eric Garcia has a proven track record of educating the industry and producing results. Eric is an internationally recognized IT and Digital Strategist working exclusively with veterinary practices. Garcia’s work has been recognized throughout the industry. Eric was voted VMX 2020 Speaker of the Year by conference attendees. He speaks regularly at conferences all throughout the world. , Dr. Andy Roark is a practicing veterinarian in Greenville SC and the founder of the Uncharted Veterinary Conference. He has received the NAVC Practice Management Speaker of the Year Award three times, the WVC Practice Management Educator of the Year Award, the Outstanding Young Alumni Award from the University of Florida’s College of Veterinary Medicine, and the Veterinarian of the Year Award from the South Carolina Association of Veterinarians.

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome everybody to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I got a great one here with my good friend, Eric Garcia. This is a sprawling, big idea, looking at the future of medicine episode. If you like episodes that make you think about what is gonna to happen in our profession the next five to ten years, there’s not a much better one in the can than this one. I really love it. We start out with this idea Eric puts forward right at the beginning as he’s heard again and again that practices are too busy and they need to hire but, when you look at the key performance indicators for these practices, their profitability is going down and down.

Maybe we don’t need to hire. Maybe it’s time to really start thinking about efficiency in our practices. And then so we, dive into that. We start talking about artificial intelligence , and how do you leverage this.

We talk about the rise of of independent practices as they’re sort of starting, we’re starting to see independent practices owners coming back. We start talking about, is there really a shortage of veterinarians in the next 20 or 30 years? And so anyway, a lot of interest in, what is the future going to look like? , let’s get into it.

Kelsey Beth Carpenter: (singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark. 

Dr. Andy Roark: Welcome to the podcast. Eric Garcia, how are you my friend?

Dr. Eric Garcia: Oh, I’m doing well brother. How are you?

Dr. Andy Roark: I’m so great. It is so, good to see you. For those who don’t know you, stop living under a rock. What, why, like, take your head out and you gotta pay attention. Eric Garcia is one of the nicest guys in veterinary medicine.

He’s a dear friend of mine. He is an IT and digital strategist. He is a digital marketer, an industry thought leader, one of the most engaging practice management speakers that you’ll find in our industry. Just a genuine all around wonderful person. He’s one of those people I like to kick around ideas with.

We were just talking before we started recording. About Eric writes a lot about unplugging, which is setting aside doesn’t any time to get off of your devices and he and I have had debates about the idea of unplugging and how best to unplug and things for years now, it’s been at least five years.

We have been discussing and debating, and we, have very different ideas about, what getting off of your cell phone and devices should look like and can look like, and we discuss them with passion and enthusiasm every time we get together, and so we were doing that before we came on here. But, 

that’s not what we’re talking about today. Eric, I was reaching out to you recently, and I’m always curious in what you’re curious about, and like, what are you thinking about, and what are you working on, and you brought up the idea that we have a lot of people in our industry who talk about needing to hire. They say, I’m shorthanded, I need to hire, and your question is often Do you really need to hire somebody, or are we in a place where we’re not working efficiently?

And maybe hiring is not really what we need to do, but we’ve been told that’s what we need to do. And so I, I really love this idea when you laid it out, because one of the fundamental questions I have in life is, You’re just not organized enough or we’re not communicating well enough, things like that. And I say that as a guy who has always looked at his days and wondered, Could I, should I have done more today? Should I have squeezed more into this day? If I was better organized, could I get more things done? And sometimes the answer is absolutely not.

You are working at or beyond normal human capacity and you, should be kinder to yourself and you should relax, Andy. And sometimes the answer is Yes, you should have gotten your stuff together and, you know, and if you had been organized and had a plan, you could have easily gotten a lot more done today and, you know, and freed yourself up to do other things.

And so I don’t know. So I just kind of word vomited all that kind out. Let me just sort of put it over to you, Eric, and sort of say, talk to me a little bit about the idea

that we’re really busy and we need to hire versus we’re really busy and we need to get more efficient. 

Dr. Eric Garcia: Yeah, it’s interesting just to piggyback off of your last point, you know,  being more efficient and having more time doesn’t always mean that you need to do more because you have time regained, right? Sometimes it’s just doing less or actually, you know, living a more structured day. 

But yeah, I think right now what we’re seeing are so many practices that are really struggling to hire people and everyone feels like they need to hire and when you talk to a lot of practices, you hear a lot of, Oh my gosh, we’re just short staffed, we’re really busy, we’re, you know, there are days of chaos and we don’t need to focus on marketing or we don’t really need to focus on growth per se, we really need to make sure that we have enough team members and that the interesting point about that is when you hear that from a majority of practices and certainly not all but a majority of practices and you look at their key performance indicators.

So we’re looking at things like what are overall patient visits looking like? What are new client numbers looking like? What is compliance and retention looking like? And what does revenue look like? And if those areas are not up and we’re not seeing enough growth, then you’re often really struggling from an inefficiency challenge in your practice.

And what’s interesting in the practices that we work with, or even those that I talk to that have numbers and workshops and things like that, it’s more often than not, practices are not growing enough to support the need for an additional person. It’s just that they’re operating inefficiently. And my concern about this is that if a lot of practices are really looking to hire and they’re not actually understanding their key performance indicators and where things are headed as a profession, that we’re going to hire all of these people, but we’re not going to have the business to support the long term play there and paying out those salaries, which is wildly alarming.

Dr. Andy Roark: Do you think that, a lot of businesses have, I’m sort of thinking of independent practices here, but it doesn’t have to be them, but, do you think that there’s a philosophy that it’s always been, if I get busy enough, I just hire someone else, because my busyness indicates that I can support them.

You know what I mean? Of just like, if I have enough work to hire another person, I will just be there. Because of how things work out. I will have enough. The money will take care of itself to support them. Is that sort of the mentality?

Dr. Eric Garcia: I do. I think so. And to an extent, you know, there’s not enough money necessarily to support them. Who takes that hit is the practice owner, when it comes to their profitability. 

And when you actually talk to people, you know, our mutual colleague, David McCormick, And you talk about what practice appraisals are looking like, and you’re asking, you know, the very pointed questions.

What are you seeing in terms of profitability? What differences are you seeing? And David will tell you himself, you know, one of the biggest challenges he’s seeing is practices are not nearly as profitable as they once were. And a lot of that is for what we just talked about. We don’t have enough business coming in to support these additional salaries that we’re having to pay for.

The people that we’re acquiring which is troublesome, but yeah, absolutely. You know, it’s interesting, I challenge practices to have, there was a great case study that was published in Harvard Business Review on a book called Digital Transformation Best Practices. And they looked at two companies.

They looked at Amazon and Walmart. So Amazon is considered to be a tech first company. But tech first not in the way that you and I can order from an app and it comes in. Not, that kind of tech. Not consumer facing tech, but operational efficiency technology. So what Amazon does when they’re experiencing high levels of growth or when they’re anticipating growth, what they look at is they look at the operational efficiency of their warehouses and their distribution centers and the technology that they use for that, right?

So, hey, we’re going to expect, you know, Cyber Monday is coming up. Let’s make sure that our technology and algorithm is optimized to make sure that we get these orders out on time and that and we’re doing it with the teams that we currently have. Where Walmart is not looked at to be a tech first company.

Walmart’s considered to be a people first company. Although I joke people first, not necessarily in the service that they offer, but people first in the, their outlook on what they do when they’re seeing growth, when Walmart is seeing growth, they say, well, we need more people in our stores to sustain this growth, where what they don’t do is they don’t step back and they say, well, what can we do?

How can we do better with what we currently have? And so as a result of that, Amazon actually has a 67 percent better performance rate based off of the revenue and their volumes of team and comparison Walmart, which makes more, but cost them a lot more because of the volume of employees they have.

Interestingly enough, though, I was at the consumer electronic trade show this January. And that is the one thing that Amazon or that a Walmart is now looking on focusing on, and they had a whole group just on what they’re doing to improve efficiency because they now recognize the opportunity to be more efficient in their stores And so I challenge practices to think like Amazon.

It’s to say oh, we’re super busy but how can we maximize the efficiency in our practice first? And then if we’re growing and we still see this And we’re still remaining busy. Then we consider hiring rather than to be Walmart and saying oh, we’re really busy We need more people because again people doesn’t the numbers don’t always support that.

Dr. Andy Roark: Have you seen, sort of this idea from, I, I think it’s, I think it’s often stress staff driven, but the easy button when we’re feeling stressed is we need more people, you know, we’re like, Oh, we’re so big. We got, we need to hire more. And I think. And again, I want to be generous here too, but I do think that. The great thing about when you’re busy and you say we need to hire more is that nobody has to make any changes.

At least that’s not how it feels. It’s like, it’s not like we need to make some hard changes and get a new operating system or get a new, you know, workflow in place. It’s like all that requires change and people don’t like change. It’s much better to keep doing exactly what we’re doing with more people.

Dr. Eric Garcia: Yeah.

Dr. Andy Roark: And so I don’t have to change and I feel like our capacity goes up and that’s the answer. that’s kind of how I look at it. It’s sort of the easy button in that way. Do you, so on sort of a scale of one to ten, how big a challenge do you think it is for most practices to really drill in and get more efficient? 

Dr. Eric Garcia: Oh, I mean, highly, huge opportunities, for practices. In fact, there was I believe it was IDEX has a study. It’s called the practice productivity index, and there’s a self assessment. In that index that practices can go through to determine what opportunities there are for improving efficiency.

And what was really interesting is, you know, so practices can, you know, kind of go somewhere like that and, complete the self assessment to see. But it doesn’t often even take a full on assessment. It’s just taking a step back and looking at all of the things that you do on a daily basis that really, way down on the team and then say is there an opportunity for us to do that?

But I’ll give you a few examples. One is real time scheduling, right? Think about how hard it is to hire csrs and to get them onboarded and to be able to you know, check people out, create estimates, take the phone calls that are coming in, manage the online communication, all of the things that they’re burdened with.

I always used to say, back in the day when I worked in a practice and I’d have to fill in, like, that’s a chaotic job. But taking the burden of having real time or giving them the opportunity to have real time booking online, dramatically reduces the volume of appointments that they’re needing to communicate, whether it’s through an online portal or over the phone and allows them to do their job more efficient or at least spend more time with the people that are in front of them in the practice.

Little things like that. There, there’s a practice recently, and I’m going to butcher the number, but it was, over 50 percent in terms of the number of people that are booking appointments online. Andy, think about how many less phone calls. that are coming in as a result of that. But the thing that I also say with that is, you know, there are practices who are like, Oh, the idea of giving my clients control to, you know, book appointments sounds awful.

And there’s a lot of fail safe mechanisms built into it. If someone puts that their dog’s been diarrhea, having diarrhea for a certain number of days, like it won’t let them book an appointment. There, there are a lot of fail safes. And so I just challenge practices. Whoever sends out your reminders, see if they have online booking.

In most cases they do, and it doesn’t cost you anything and you can work with them to set it up. You know, having artificial intelligence produced medical notes is another huge opportunity for veterinarians, but now it’s not even just that, right, it’s also using the right tool to be able to maximize efficiency.

You know, all it really does is you download an app on your phone or any mic enabled device. And it will record the entire appointment and it’ll start the SOAP note for you and it’ll clean it up. It’ll remove any kind of personal conversations. You know, if you’re talking to an owner and you happen to know their kids and they go to school with your kids and you’re talking about that, like it, it eliminates all of that from the medical note.

And what we’re actually hearing is that a lot of practices are getting even more accurate medical notes because AI is listening to the whole appointment. a lot of times you’re producing the note at the end of the day, if it’s the same day. But it’s not even just doing that anymore. It’s also doing that in an efficient way.

So there are a lot of AI tools that now will start the medical note for you in your PIMS, so making sure that you even use the most effective and efficient version of that tool. Fun little story real quick is I started recommending this to practices at a group that I speak to every year.

And, so I introduced it to them at some point last year and, you know, they were a little skeptical about it. Some were really excited. And so I always tell people, try it, you know, you should always try something at least, once or twice. And if it doesn’t work, then I don’t ever say never just say it didn’t work right now, but let’s try it again in the future.

And so, so this practice under did she tried it? And her husband said, well, I have no idea who he is, sent me a message to thank me for recommending artificial intelligence for medical record keeping to his wife, who is now leaving work early. And that kind of goes back to the start of our conversation is, you know, maybe it’s just as simple as leaving work early, or having your lunch.

It’s not necessarily that you need to do more. She didn’t stay two hours later do other things. 

Dr. Andy Roark: I know I get it. This is my own weird neuroses of like, I’m like I should do more productive things normal people like I would just like to go home and see my family and I’m like I guess you could do that. Like, ha , yeah, or, or you could write an article about something that people don’t really care about and just

Dr. Eric Garcia: You and I should work on that, yeah. ha. Ha, Yeah.

 
Let’s get. Get back into this episode. my, so my thought, so here’s, a little bit of my concern. Let me ask you how you feel this. And so, okay, so I think the writing’s on the wall for where we’re going with artificial intelligence.

Dr. Andy Roark: I think that artificial intelligence is going to do a lot of things, but I think one of the big things it’s going to do is remove the low level, tedious work. A lot of low level teeth, like a lot of just writing things up, like, like records and stuff like that. It’s not about practicing medicine.

It’s about taking these sort of mundane things and taking them off of our plate. And so I think that’s a beautiful thing. My concern a little bit is if you push doctors right now, I don’t know if the tech is fully ready for what we want it to do, and I’m curious what you think about that.

And you, it’s if you push people too early to try something, and it’s not ready, and it breaks down on them, is it that much harder to get them into it later on. So, so do you think it’s worth fighting the battle now to try to start to try out AI stuff in your practices again? I have.

I’ve heard similar stories to what you’re talking about as far as a recording device, your cell phone in the exam room talking about, you know, pet owners, kids, and family, and all that stuff gets cut out and captured. But also, I look at, Zoom AI recordings of meetings that I have been in, and they are Looney Tunes sometimes, and it’s, it is quite funny, what AI thinks is happening in the 

meeting. And so I’m like, I don’t know, do I push, do I fight this battle now? Or do I wait till 2026 and then fight it there? And I think it goes a lot easier. How do you kind of get your head around that Eric? Are you like pedal down go for it now, or are you like I could see waiting a little bit?

Dr. Eric Garcia: Yeah. So a hundred percent pedal down and do it now And I’m actually really glad that you brought up that point because sometimes the problem is when especially when we’re talking about technology is that because there are so many options, you know, not everyone is as good, you know, not every tool is as good as the other.

And so, you know, just because someone says they do AI for medical record keeping doesn’t mean that they’re at the point in their business to have validated that. because they perfected the nuances of, you know, the veterinary appointment. And so, you know, I always tell practices, you, have to kind of do your due diligence into the right tools that are out there.

Talk to your colleagues, see which ones everyone seemed to be using, because they’re the ones who’ve already had, you know, and I say maybe a year, two years of feedback from, you know, hundreds and thousands of veterinary appointments. The problem with AI for medical record keeping is that Andy, I kid you not, there are probably a minimum of 20, 25 companies right now doing it.

And some are way further along than others. Is it perfect? No. But is it saving you the amount of time from having to do this thing yourself every single time? Absolutely. And that’s where practices are, you know, most practices will be quick to tell you, It’s not perfect, but it’s perfect a majority of the time and it’s saving me a lot of time and I have practices I was visiting with one on Friday of last week and the owner, was just like he was like I was against it.

I was against it and he’s now You know, he’s kind of addicted to it, but I to further frame kind of your question is I think I wonder about the long term effects of over reliance of AI. That’s where I do worry a little bit, especially, you know, and I’m not a veterinarian, but especially the reliance of it.

You know, when it comes to, you know, some of these tools are right, differential diagnosis for you, they’ll interpret your lab work. And so, when we’re looking at things like that, what I’m going to question is who’s feeding that? and I, that’s where I would rather wait for a, you know, an Antec or an IDEX or a massive company that is feeding it millions of cases and training it.

Then someone who’s using some iteration of chat GPT for medical based decisions. Like that’s terrifying.

Dr. Andy Roark: Yeah no, I completely agree with that. the idea that we’re feeding chat GPT into, to talk specifics of medicine is terrifying. Well, that’s it, you know, I talked Dr. Jules Benson at Nationwide, and he’s just a massive data nerd. I love Jules. but he talks and says, you know, your AI is only as good as the data that you train it on.

And so I think that you’re, I think you’re absolutely right. It’s going to take a, big data set whether I think nationwide is doing some really cool stuff. Their pet health zone I think is really a fun tool. It’s not AI but it is a neat way of leveraging the huge amount of data that they have collected over the years about illness and what breeds are likely to have different presentations and Different illnesses and things like that at different stages of their life.

If you haven’t seen it, it’s cool. But it’s got to be a player about that size who can say we’re going to start feeding this the stadium. I, you know, I look like Banfield for example, VCA, some, big corporation like that’s got, you know, they’re seeing tens of thousands of patients a day.

I’m like, boy, the potential they have to be able to generate something. But again, this would be a huge undertaking. but, I’m with you. That’s, I think, that level of change is coming. But even then. Even then, it’s still going to be, it’s still going to be about the data that we put into the system, you know what I mean?

So if you have a PET and you’re looking at the PET, and you feed the blood work into the machine, and it comes back and says, Well, based on this blood work, this is what you need to do I still would be very hesitant to do that. to go forward without integrating that information into what I’m seeing with my eyes, what the pet owners are saying to me, like those things are still going to matter, and it’s going to take someone on the ground to put those pieces together.

And so anyway, I think it’s, I think it’s going to be an interesting future, Yeah, I just, I’m excited about it, but I am also definitely wary of pedal down. The other thing I’ve seen a lot in the industry is the use of the term AI in ways that I think is probably inappropriate. 

Dr. Eric Garcia: It’s so, it’s a marketing term now. 

Dr. Andy Roark: One hundred percent it’s a marketing term now. It’s artificial intelligence. It’s like, oh, it seems like a very 

Dr. Eric Garcia: I was just going to say algorithm AI, completely different things. Yeah.

Dr. Andy Roark: Yeah, but I have a hundred percent seen very basic algorithms of you know If they select this then you do that and it’s like that’s not AI that is just following a basic pathway but I see a lot of it’s just because anything that has a I tied to it gets a lot of attention And it gets investor dollars and stuff But there’s it is a little bit of buyer beware right now about what are you really getting and what are the capacities here?

Dr. Eric Garcia: And this is why, you know, I always tell practices go on Google, type in veterinary artificial intelligence and then I schedule a demo with at least three to five of them. And I always tell practices 10 minutes is as long as this demo should be. If someone can’t convince  you of their value in 10 minutes, then move on. Because what happens, Andy, is they’ll get you on the phone for an hour and you’re like, Oh, it sounds like they do everything. I don’t, you know, and you’re just going to sign up and, you know, 10 minutes to three to five demos. So block an hour off your time, ask them how long they’ve been around for, you know, ask your colleagues and then ultimately, you know, determine what to write for your practice.

Dr. Andy Roark: What do I want in this demo? Right. Cause I show up and like, all right, I want a 10 minute demo. what are the what are my objectives going into a demo

Dr. Eric Garcia: Yeah. So it’s going to be different for every practice. So this is kind of going back to looking at the overall opportunity AI tools right now. very, low cost AI tools that don’t  integrate within your management system. they’re just recording the, conversation and they’re producing a soap note.

And so if you just want to try it out. And you’re looking for something super low cost to do that, then, you know, see who does that better, right? Can you train the, soap note to predict certain recommendations based off of, you know, if a diar a vomiting diarrhea dog comes in and it’s writing your soap note, and you’re a veterinarian who loves to dispense metronidazole for it.

You know, can you train it to automatically write that as a part of the plan for you? Where maybe another doctor has a different preference or they, you know, they go to food first, whatever it might be. So what are the levels of being able to train writing the medical note based off of the veterinarian that’s seeing that appointment?

So asking that, are you also looking to use it to produce a, summary follow up? In layman’s terms for the pet owner, not all AI tools do that. So is that something that you want to do? Do you want to be able to provide something for the owner to be able to leave with to summarize the visit and take home and have an explanation in a way that’s easy for them to understand?

Is integrating it in your management system a priority? do you want it to literally open up your management system and start their medical note for you? Do you want it to be able to to send health questionnaires ahead of the visit and then interpret what seems to be the cause before, you know, they even show up to the appointment because they completed a health questionnaire.

So looking at all those little nuances and trying to determine what problem are you trying to solve and, specifically in this area, how much do you want to go into it? Some practices want all in, some are like, Hey, I just want the basics and there’s nothing wrong with either. um,

Dr. Andy Roark: I did some work in the Netherlands a couple of years ago. And I went around to a number of different practices that were there, and I was sort of trying to get my head around how they work and how they function. And, you know, in the Netherlands, it’s really expensive to hire people. Like, you have to pay huge employment taxes. I, it is, very, again, that’s sort of like the cost of a robust social safety net. which, they have and that’s, how they roll. And so, there’s that. so, the upside is Big, nice safety net. Employees get nice, you know, support packages, things like that. Downside is, it costs a ton to hire somebody. And so, the vet practices over there have responded by being very small. the majority of the practice I went into had literally three employees. it would be a doctor and two technicians and, or one technician and one assistant. And they answered the phones and they checked people out.

And like, that was it. There wasn’t a front desk. It was those three. In the building doing that, and it was just interesting. I’ve always sort of looked at that and sort of been like, you know, this is where the model goes as we sort of pay people more. And if you want to raise salaries and things, this is one way that goes down.

And again, it was just the practices were smaller and they did a lot more with a lot fewer people. Eric, when you look into your crystal ball and dial it in for 10 years from now, Do you think practices are smaller than they are today because we have gotten more efficient and we are paying the people we have more?

Do you think that they’re about the same size as far as number of employees that we have? Or do you think that they have grown and we have larger practices possibly leveraging, you know, Fewer, maybe fewer practices overall. The big guys kind of get bigger. What do you, see ten years from now?

Just as you kind of try to see the future?

Dr. Eric Garcia: so I would definitely think they’re smaller, but they’re efficient not just in the fact that they’re smaller. I think there will be more widespread utilization of a lot of the things that we’re talking about today and that we still don’t even know are coming down the line when it comes to Just automating a lot of the tasks in the day to day running a hospital and so I think they’re smaller I think they’re more efficient and I think that you know, they’re gonna thrive and they’ll be great You know, we’re seeing this kind of at least in the practices that we’re seeing this resurgence of you know, independent ownership And when you ask them, you know, hey, what are your long term goals here?

You know, what are you trying to do in the next three to five years and longer than that? You And I would argue to say, and I’m not, this is not statistically relevant by any means, but I would argue to say that probably 100 percent of them also they want to stay small. And I think a lot of people that are starting practices are people who sold, you know, recently or have always had this dream of owning, but they realize that sometimes bigger isn’t always better.

And so I do think that there will be this kind of, you know, massive volume of these just smaller practices and, you know, practicing the medicine that they want to practice in terms of, you know, are they going to do surgery? Are they going to do dental? I think we’re seeing a lot of practices that are like, we’re just going to see wellness visits or we’ll just do, you know, basic diagnostics and refer everything else out.

That’s what I would guess. But you know, it’ll, be interesting for us to have this conversation in 10 years. Like, I know we’ll have and see where’s your head at? Are you thinking also small based off of kind of your

Dr. Andy Roark: I, yeah, I do actually. Yeah. I, do. I think one of the things I’ve been thinking a lot about recently is this. And so, you know, I, you and I were there together. I think we may have been in the same room. I remember in about 2010, 2011, the drum beats were really loud. that we had a production problem of veterinarians in terms of overproduction.

We had these new vet schools that were opening up and, class sizes were expanding and the drum beats were really loud. And it was, just common. It was the, it was common sense wisdom knowledge that we had, we were making too many veterinarians and veterinarian salaries were going to plummet. and that was it. And I just, I can’t emphasize enough that it was so widespread. It was talked about constantly. And then, I was in a room one time and Danny McVitie was in there from Lap of Love Pet Hospice. And so, and I think it was, I can’t remember if it was a panel. or if it was a lecture that I was doing and Danny was in the audience, but someone was talking about this overproduction of veterinarians and things like that.

And Danny raised her hand and she said, you know, I’m the CEO founder of Lap of Love pet hospice. And, uh, you know, I keep hearing about all of these veterinarians that were overproducing. Can you tell me where they are? Because I desperately want to hire them and I can’t find them anywhere. And then head started nodding in the room of I also want to hire them.

Cannot hire a veterinarian and just like that Eric the whole industry in my mind It just swung the other way and suddenly we were freaking there was never a happy medium It was never like oh we turns out we might not have an overproduction problem. Let’s just be happy for a while It was nope It was one extreme the world is ending and to the other extreme the world’s endless thing And so then ever since then we’ve been in a we don’t have enough veterinarians Problem. And so now you’ve got this stuff in the AAVMC, who has a vested interest in making more vet schools and turning out more people. They’re saying we’re having shortage, but the AVMA is really pushing back and saying we don’t aren’t, we don’t agree with this assessment. And I think it’s easy to kind of dismiss the AVMA sometimes because they can be kind of crotchety in their way.

And they can be a little contrary. But I can’t write them off in this one and say, ah, those guys are wrong. I don’t know that they’re wrong. And so anyway, I’m, looking at this and I, and I’m looking at this question and go, do we have a, like a, an undersupply of veterinarians in the next 30 years?

Is it going to be this catechism thing where we don’t have enough people? I don’t know that I’m sold on it. I think, when I look into my crystal ball, I think 10 years from now, I suspect we’ve probably got about the same size practices, but, and this is sort of pulling in something from human medicine, I think that we right now are starting to see administrative bloat in vet medicine that we saw like 15, 20 years ago in human medicine, where all of a sudden there are these, there’s a lot more middle managers, there’s a lot of, you know, area managers, things like that, and so some of the, practices are getting bigger, but they are having more sort of administrative people as opposed to people on the ground seeing the patients. Does that make any sense?

Dr. Eric Garcia: It does. and it’s interesting because you’re right. Even thinking in the last five years, just the volume of roles that are being created that weren’t typical in the average veterinary practice, even seeing, you know, back when you and I probably started  knowing each other, like we’re, it was, you know, everyone needs a practice manager.

And then now everyone needs an assistant manager and IT and marketing and all of this. And I agree with you. I think that. becoming very top heavy and there might be, you know, some people that are going to step back and look at that. I think the interesting thing, Andy, and I think it’s worth mentioning is that I think regardless of the conversations that we’re having in the profession about, you know, in this case, you know, shortage of veterinarians or whatever it might be, I think sometimes what happens is as practices, we kind of look at that and we’re like, Well, this is the reason I can’t do X and the reality is, that yes, the, there are always going to be problems that, that are, that the profession’s trying to predict to get ahead of the future.

But what you should really be focusing on is doing whatever’s going on in your practice really well and not using these exterior things as excuses. Because I see, I hear this all the time, you know, practices are, oh, we can’t hire well, but no one can hire because there is a shortage of veterinarians and it is what it is.

And I would challenge you to step back and say, well, no one can hire and we haven’t hired anyone. So maybe there’s a different approach that we can take to do better because it becomes very problematic where you go somewhere and you’re like You can’t hire a veterinarian and it’s actually there are people hiring veterinarians and they’re not all corporate And they’re not all paying these high bonuses.

There are people who are selling themselves a lot better And who are selling the culture of that practice a lot better beyond buzzwords and who are actively working at it And so that’s where I challenge, you know practices To just kind of say all right. Yeah, these there are things that are working against us But we could probably do better because the chances are is you probably can’t Yeah.

Dr. Andy Roark: I think that there’s a real danger right now that this has become a mantra when you say, wow, we’re really stressed. Well, that’s just because you can’t hire anybody. And you go, well, that, that would be one, one possible approach, but it’s always dangerous if that ends the conversation. You know what I mean? It’s almost like, well, there’s this thing that’s outside of your control. And so, you just stop your search because this is what the, you know, the Earth has given to you and there’s no way around it. And that’s not really true. Eric Garcia, where can people find you online? 

Dr. Eric Garcia: Anywhere ericrcfl.com or anywhere at ericrcfl on social.

Dr. Andy Roark: Cool. Thanks so much for being here. Guys, thanks for tuning in today. Everybody take care of yourselves. And that’s what I got for you guys. Thanks for being here. Thanks to Eric Garcia for being here. If you ever get a chance to see Eric Garcia’s lecture, you should definitely do it. He’s a great speaker. If you ever get a chance just to talk to him, he is a, just a genuinely wonderful person. He is up there on my list of favorite people that I know in the profession and it’s just, what a wonderful list it is.

We have so many great people in this industry and this profession, but Eric Garcia is right there at the top. So anyway gang, thanks for being here. Take care of yourselves, everybody. I’ll talk to you later on.