The profitability of Asclepius

I recognize that my veterinary clinic; Jarrettsville Vet, is succeeding because we are not following in the ever increasing footsteps of the rest of the parade of hospitals around us. I recognize that as we remain independent and committed to our patients and the people who call them family, others, in ever growing numbers, are becoming financially focused institutions. Under their guise of care people are being targeted for manipulation as they are held emotionally hostage for their pets care as the commodity. It is obvious that as so many other veterinary clinics fall into corporate, conglomerate hands, focused solely and singularly on profits, the wave of supportive leadership to make this happen is the keeping of the guards to allow passage of currency. The veterinarians are the backbone of every veterinary practice. The engine that keeps the machine allowed to run. They hold such power, permit the profession to promulgate, and, now more than ever before in our history, they are in such short supply that we are begging for more of them to find our unanswered want ads. 

Given away at just a few days old someone took mercy.
Often the littlest lives need the most compassion.

With any great demand comes innovation, competition and incentives. The ability to find a veterinarian in any of the traditional ways has become impossible. You cannot place an ad in the local, state, or country publications and get even one response. You can try to recruit from the veterinary colleges, but you will be met by large corporately run HR banks with their platoon of jesters who now recruit students at the freshman level as "ambassadors" who are paid to promote their hospitals and essentially own the student upon graduation. As with all choke hold demand there is great profit in finding that unicorn. So gives rise to recruiters. 

 Today I received an email from one. Here's how that exchange unfolded.

Good afternoon Dr. Magnifico, 

I am sorry you have not had good luck with recruiters in the past. I try very hard to be transparent and have never been accused of being unethical. I have been a veterinary recruiter for 30 years and love the industry and what I do.

I have attached the document that explains how we work and associated fees.

Looking forward to hearing back from you.

Gwen

The contract is as follows;

Contingency Retained Recruiting

Off-site identifying, sourcing, and recruiting

Off-site telephone interviewing

One year replacement guarantee

Fee: 33.5% of first year annual compensation of each candidate hired. To begin process, sign agreement

and pay retainer of $3,900.00. Retainer is deducted from invoice of candidate placed. Only one retainer is

required per year, regardless of how many open positions we are recruiting for at the same time.

Fee is calculated at offer and acceptance of candidate chosen and is due in full within 5 (five) days of receipt of

invoice. Payment is due upon verbal offer and acceptance. If payment is not made on time as agreed, billing

fees, interest, and late fees can be incurred.

Retainer

Retainer is non-refundable. In the event Client hires someone outside of VetProCentral services, the

retainer is available to use on any placement within one year from date we are notified that the original position

has been filled.

Details – fine print is always necessary!

Signed contract and retainer are required to begin the search. Retainer is non-refundable. Signed contract

and retainer are required to begin the search. Retainer is non-refundable. In today’s market, we strive to offer a

superb candidate experience as well as meeting client’s expectations. With that, a streamlined hiring process is

essential when entertaining the best candidates available. We have adopted the 2/5/5 premise to achieve those

goals. What does that mean? With permission from the candidate, we will present them to you for consideration

after the initial phone interview with a VetProCentral team member. To follow, we expect a decision from our

client to either move forward with a candidate or pass within two days of submission. Thereafter, an interview

via zoom or on-site is to be scheduled within five days. Following a decision within five days of the on-site or

zoom interview, a second interview is to be scheduled or an offer will be extended. This hiring tactic is used to

give you a competitive edge against other practices. Our goal is not to rush our clients to an offer, but simply to

move the interview process forward and ensure we do not miss out on excellent candidates as they wait in the

interview pipeline.

Replacement Guarantee

Each Candidate placement is guaranteed. In the event a recruited and subsequently hired candidate is

terminated for cause during the first year of employment, VetProCentral will replace candidate at no charge to

Client. Guarantee follows title of person placed and location. The guarantee set forth in this paragraph will be

void in the following circumstances: (a) Client chooses not to replace the candidate; (b) Client decides to

promote from within to replace the candidate; (c) candidate is under contract for one year, and the contract is

determined not to be renewable by either party, prior to year-end or (d) the candidate is moved from one Client

location to another.

My response;

Jesus Christ. I would have to euthanize half of my patients to increase fees enough in the other half to pay for this. 

Insane. 

When you hear about the cost of care for veterinary care going up and the subsequent loss of access to care because of this, and, all of the pet adoring parents who will never get another pet again because they cannot afford to, please recognize your part in the landscape that vetmed has turned into. 

I just think it’s super important that we all share that responsibility. 

You are either a part of the solution or a part of the problem. 

May there someday be empathy for compassionate care again. 

This is disgusting. 

Krista. 

Earl, one of our rescues on his last day with us. He was adopted by one of our most beloved friends.
Here's to living the best life ever!

It will come to a place where this is really all, and only, about the money. Where only the rich can have pets, and only the richer care for them. There is a tipping point, a continent of opportunity for those with an entrepreneurial spirit to propel them, and a whole devastatingly destructive tidal wave of culpability to follow. If independently run veterinary practices continue to sell out to corporately managed investors at the rate they are the price for care, the salaries paid to do their bidding, and the death toll of those treatable cases will continue to rise. Who among us doesn't want to be paid more? Who among us wants to work harder, see more cases, and try to hold the line for ethical care at affordable prices against a wave that grows bigger, hungrier and more powerful? 

My adorable Seraphina. My muse, my salutation salvation, and my Why.

There is a cost for each decision all of us in vetmed make? I am bombarded by it every day. Today a person drove 11 hours to see me. He was afraid to go anywhere. Afraid his cat is going to die from a treatable disease that no one else wants to help him with. Eleven hours away I had to tell him that his cat was not treatable, savable, and that all he feared was about to unfold. I told him this for $500. The cost of an exam, blood work, xrays, radiologist reviewed, fluids, appetite stimulant, antibiotic, and a steroid as our last Hail Mary attempt to make whatever time she has left as pain free and peaceful as able.

I know he drove by hundreds of clinics who would have given him the same advice, for about the same price. I also know he drove by hundreds of ER's who would have told him he needed $4,000 to get started on his journey of futility and not been honest with him. He would have felt shamed in not being able to afford the list of recommended line items to punt his cats diagnosis to a specialist, in network, of course. 

Daisy. Getting ready for her dental.

I wonder if my end in vetmed will be left with me as the only DVM name on our shingle? 

There is a price for high wages. A cost to only providing care to the elite, the wealthy and the expected annual salary of $200,000 per vet and the 33% of that it would cost to be able to procure a vet from this agency. Veterinarians out in the world looking for employment hold great leverage and power. They expect sign on bonuses of over $50,000, annual pay of over $150,000, and every other benefit imaginable. While I recognize the great healing powers of all veterinarians, I also recognize that no where in any recruiter flyer, corporate descriptor, and "about us" website section is only about quality of care, work-life balance and income. There is not one single word, inuendo, or iota of responsibility with regard to the reason we all came here. There is no hint of caring, compassion, or the incredible magnetic force that is caring for these pets who hold our hearts, and now wallets hostage to the web of greed that we are engulfed within. There is no mention of how fulfilling, inspiring, and impactful it is  to save the life of a companion that ties another human to wanting to stay within humanity. The gift that I receive day in and day out in saving the savable lives, showing compassion to those I cannot, and never denying that there is hope for each one of us in even the darkest of days is the elixir to all of our collective miseries.

When will vetmed, and the powers who hold them in check, become honest about transparency with these influences? What I will call cost of culpability, be called out? When will moral integrity with all things that fall within the net of vetmed reign supreme again? When will the tipping points of treatable tip back from profitable? When will we all wake up from this catastrophic speeding train and recognize we burned every bridge as we transited to indifference?

From Wikipedia; culpability;

The concept of culpability is intimately tied up with notions of agency, freedom, and free will. All are commonly held to be necessary, but not sufficient, conditions for culpability.

A person is culpable if they cause a negative event and
(1) the act was intentional;
(2) the act and its consequences could have been controlled (i.e., the agent knew the likely consequences, the agent was not coerced, and the agent overcame hurdles to make the event happen); and
(3) the person provided no excuse or justification for the actions.^[2]

Every decision that I make as a veterinarian, a practice owner, and a human being, has influences on others. The meekest being the most obviously influenced. If I even entertained the idea of signing this contract with this, or any of the other recruiters, I have to pass on the expense to the patients I came here to care for. Period. The idea that the profits of the clinic not being passed down to the staff as unpaid wages is not present at this clinic where we post our prices, wear our hearts on our sleeves, and never shame based on financial limitations. We also are not afraid to try to save a life, even when we need to cut diagnostics to do so. We are honest in our mission, purpose, and compassion. It is not a tagline to infer trust that we simply break when you are not profitable to our business.

It is wonderful to have the newest, brightest, shiniest, fanciest, modern pieces of equipment, but if you can only utilize on a tiny segment of the patients who need them it is a detrimental restrictive asset. It is a choice to be the Bower bird and not the Asclepius we were trained to be.

Rio. My heart lies here. In the stories of these lives and the memories of a life rich beyond the measure of societies currency.

It's time to be honest again about why we are here. If you are a product of a sign-on bonus that compelled you to have to turn treatable patients away, and you told yourself that pets are a privilege, and that these patients with their treatable ailments, are "not your problem" because the CFO at your employers office will not permit you to try to find an affordable answer, then the issue with integrity lies at your feet. We are all responsible to help the animals who come to us in every capacity we are able.

One of the four blind puppies we have helped to rescue.
These are the reason we came here. Why this profession will always be more than a recruiters ability to sell, market and negotiate.

For more on this please follow this blog. Please find the real-life cases on my YouTube channel and follow along with us in our day-to-day lives on our Facebook page.

Remember we are all here together. We all came into vetmed for the same reasons. None of us will grow rich on saying no, denying chances, and killing for the profits that bankrolled the guys who never have to get their hands dirty. Who's side are you on? 

Goodnight Gwen. God bless all those tiny creatures who are still out there in need, and the souls who still find their lives valuable enough to see the miracles in the chances of just being kind without a balance sheet.