Fresh Meat

You Don't Know What You Don't Know..

Penny. One of our dearest friends and a local rescue

The staff have notified me that you are headed to a nearby practice that has just sold to corporate. I want to respectfully and sincerely share my experience and insight on this decision. And apologize for the tone. 

I spoke to the seller, (a veterinarian I have known for the 20 years I have been a veterinarian), about two weeks ago. She told me that she sold to corporate, (a corporate company I also know), and I told her that I understood why people do it, I just could not understand her doing it. She was the last and only other practice owner besides myself who I believed would never imagine selling corp. 

Here’s what I don’t think you know. You are young. Just starting,  In debt yes, but you still have your heart, compassion and integrity. Your sign on bonus and contract are going to challenge that. Corporate companies have no interest in patients unless they have deep pockets. You will be expected to turn away or euthanize treatable pets because they are not inline with their profits. Period. They don’t care about anything unless there is a profit driven reason. They only care about you because you have a license and a contract. Without them they don’t care about you either. I could put you in touch with a dozen former corp vets who worked for them. They would all verify this.

If you think being in debt is the worst part of your current position it’s not. Being burnt out and turned into an indifferent person who doesn’t love vetmed is. Even worse, becoming a part of the statistic that is so shameful we bury it. We can talk about all of the myriad of reasons that veterinarians choose suicide, but, losing ourselves in the process of trying to care for others is at the forefront. 

Corporate medicine is so insidious in our profession that they now start recruiting the most debt-ridden students, (it is not a coincidence they start here), in their first or second year of vet school. By third year they have "signed." They are receiving "pay" in the way of stipends and expected to take their internships at their corporate run practices. They are constantly groomed and persuaded to pay back the favors enticed by large (always secret) sign on bonuses and long restrictive contracts. The contracts are the most horrific parts of this recruitment trade. I don't know if anyone on the university side has these graduates interests on their job description, but I know that when I was in vet school I at least had a professional advisor on campus. A recent new grad was sharing the details of the contract they had signed. $160,000 for 60 hours of appointments. Sixty hours is twice what any of the vets at my practice carry. The state average is about $130,000. This is endangerment labor. I strongly challenge the viability of anyone being able to learn effectively, care for patients effectively and then being locked in for 5 years!? An internship and residency last 5 years and when they are completed the expected salary triples. What is going to happen to this student? She is going to want her life back. Or, she is going to quit vetmed feeling like toast.

I never require a contract with new vet’s because I never want them to feel obligated or pressured to be anything other than who they are. If you aren’t happy here I want you to find the place you are. You cannot give your heart and soul and feel purposeful and good about yourself if you are contracted to anyone. 

I know this is not what you want to hear. But, I want you to know I am here for you. 

A veterinarian who sells their practice to corporate is asked to stay around for awhile. Help it look like the transition is gradual and under their guidance and acceptance. Maintain a facade as the new regime takes hold. It is all a part of keeping the most profitable plan by the new owners. In exchange for a whole lot of money the departing practice owner has to give up all that they built and all of his decades of building something amazing to vultures. They will always know that they profited from this sale and their staff clients and patients will pay for that. 

I hope that you find a place that you love. And love vet med as much in 5,10, and 20 years down the road. Never ever let anyone take away your passion or compassion.

I wish you well. I hope I am wrong about the direction that the clinic is headed for. The seller thinks it will remain the place she built and is proud of. I hope she is right too.

 Krista. 

Spencer, always shy and skeptical.
A local rescue

This is the letter I sent to a former employee who is started work at a corporately owned practice upon graduation. He has a big heart and he has worked hard to get into and out of vet school. He is like so many students who are lured by corporate reps who promise all sorts of things to get them to enlist. I spoke to one student who was given a big sign-on (about their first years salary ($140,000) for a 5 year commitment and a 60 hour a week appointment schedule. This leaves them to make phone calls,, review blood work/diagnostics and write up their cases on their own time outside of that. I would expect that will leave them working 80 hours a week. They are now earning $33/hour, and miserable.

What you don't know, you don't know. Maybe the first person who approaches you with the shiny objects and the impressive dollars doesn't have your best interests in mind? Maybe it's time the vet schools take a stance on predatory practices if they aren't already one themselves?

Maybe it's time we start asking some hard questions as consumers and start whistleblowing for the sake of our patients, our emotional bonds with them, and the people we entrust with their care. (More on this to follow).

Add reaction

Corporate Acquisition Inquiry

I get these phone calls and emails daily. It seems that as the available pool of private practices gets smaller the tactics and tactful phishing gets more invasive and obnoxious.

Here is todays example. I have half a mind to add the phone number. The volley serve to texting me at 5 pm on a Friday.

Hi Dr. Magnifico, this is XXXX from VetEvolve. I hope it's okay reaching out by text. I am very interested in learning a bit about Jarrettsville and your plans for the future of the practice. Are you available for a quick call next week to introduce ourselves? 

Looking forward to hearing back.

XXXX

Practice Partnership Specialist 

xxx

George.
Multiple unblockings (UO) and a PU surgery

Myreply;

If you are reaching out bc you work for a corporate entity seeking ownership than no. It is not ok. It is predatory, rude, disrespectful and unprofessional. You are also working for people who intentionally and purposely make pet care so expensive it costs pets their lives. It also costs pet parents their ability to trust other veterinarians. Think about what your paycheck costs pets. 

Doc, linear foreign body surgery.

Thank you for sharing your perspective. I do appreciate your passion and commitment to the veterinary profession..and also the well-being of pets and clients alike.  

At Vetevolve, we are not about being predatory or undermining the trust between veterinarians and pet parents. Our focus is to support practices, maintain each unique culture, and provide resources to help teams thrive and better serve clients and patients. Affordability and access to care are priorities for us and we are striving to make a positive impact.

I understand completely if you aren't interested in further discussion, but I want to assure you that our intentions are grounded in supporting and preserving the veterinary community, not taking advantage of it. 

If you would ever like to share more about your concerns or ideas for improving the industry, I'd genuinely value the opportunity to listen. 

Warmest Regards,

XXXX 

Lola, pyometra surgery

I would be shocked if all of that pitching garbage had any teeth. Let me know which patients of the other corp owned practices who are turned away due to financial restraints that I can send your way for affordable care   I'll give them your name. 

Send me one case that you made affordable. 

You are drinking the kool aid. 

I just visited your website.  There isn't one word about patients. Every single page and line item is about people. So if your website is any indication of how much you care about your patients it's zero 

And for the record my husband and I have 40 years of combined service Bn the navy and coast guard. 

Don't say I didn't warn you. Eventually some bigger fish will send you packing. They treat their people as bad as their patients. 

Dixie, Pyometra surgery

I assure you,  my heartfelt thoughts are based on what I witness.  I don't have cases on hand from the hospital level...but our integrations and operations teams would be sure to provide  for any owners who are moving forward with discussions.

In reference to our website, I can direct you to the resources tab where there are videos and posts... where the veterinarians speak about community and their clients. By implication clients are happy because their pets are taken care of ...but you raise a great point ..a heightened awareness of protecting and caring for the animals could be more prevalent instead of mostly mentioning vets and their teams.

As for your combined service, I appreciate what you have done for our country... I admire all branches of our military. 

Lastly, I have my eyes wide open here....and it's not my first rodeo in M&A.  You have a valid point that companies merge or close without warning.,.being tied to PE does come with occasional risk...but if I can add on to the culture from what I have learned in the past few decades in the space, I will. So many of us here have come from other places and want to right some of the wrongs we have seen in the past.  I don't view that as having Rose-colored glasses ..its just because someone has to take the first steps to do it right.  

Thanks again for your thoughts..I do value your opinion...

Have a great weekend and much continued success this year. 

Garfield, trauma, fractured jaw

There is not one single thing that is in place in your organization that puts pets first. The whole concept of the corp ethos is about profits over individuals. As a civil servant it is unethical and deceitful to even try to portray otherwise. 

At some point you will ask yourself what your efforts contribute to our society. What legacy you are building. Who you are, who you represent are the antithesis of what the pets who we consider family need. They need love, compassion and kindness. Medicine should embody this in every molecule of our being. Every action, word and decision that we make. 

It is the dawn of shooting CEOs in the back and the public cheering them on for it. This is the world you built. These are the consequences of greed, wealth and your idea of power. 

It's shameful. I'm not afraid to tell you that. We, as the spokesperson to our companies, have nothing to say to each other. 

As the individual You just aren't looking deep enough into your own mirror. 

Seraphina and Dr Ahrens

...and PS XXX, my success is infinitely easier to achieve because of two factors; 

1. Your business model makes my new client patient appointments robust. Your "one and done" visit ratio is much higher than mine. You will price them out of care once and they will never come back. That's the price of playing with the lives of our family.

2. I possess qualities you will never have; genuine compassion and utter determination to save lives.

If you aren't saving the souls you came here to serve you are selling yours short. It is not about the "if they can pay we can help" it is about altruism and your own humanity.

"If you feel pain, you are alive. If you feel other people's pain, you are a human being." Leo Tolstoy.

If you are a veterinary professional looking to save the lives you came here to be the kind hand of healing for then please reach out. Medicine was never intended to be driven by profits alone.

For more on the cases above see the other blogs, my YouTube channel, Jarrettsville Vet Facebook page, and Instagram.

The Tipping Point. When There Is More Behind You Than In Front.

The tipping point.

There is a place, a moment, a collection of revelations, where you realize, bring to your own attention, that you are looking back, (horrifically in some cases even attempting to relive, revive and recollect the exact details of what was before), more than looking forward. 

That place where there is more behind you than in front of you, and not only is that the truth, but worse, your preference defers to back versus ahead.

Gracie. Just rescued. Her mouth was soo diseased the smell would knock you over.
All of her teeth had to be removed. This is her waking up.
She was a different (soo much happier) cat 24 hours later.
The degree of neglect she came to us with was pitiful and compelling.

In the misery of many a childhood moment I would sit, close my eyes and imagine the magic that lay ahead. Too often the allure of what might be. What I could salivate over. Some lustful moment. A momentous accomplishment dreamt of but yet to be fulfilled. A far away land with all of its exotic flavors. I got by, (a theme song from my favorite Grateful Dead anthem), because I projected forward. Those invisible carrots of motivation lay just at the tip of my tongue. Propelled me forward through what turned out to be some pretty traumatizing growing up. 

At 50ish I have realized that the carrot has shape shifted. It no longer hovers above calling. It lays beside me waiting. The small dirt-dusted, blunted, jaundiced nut in a collection resembling a sickened nest of eggs to ride out the Winter. 

The snowdrops and the crocus.
They remind me to believe in beginnings,, even after all of the endings.

Unbeknownst to me the tipping point hasn't evolved into a concession, rather a gentle acceptance that the To-Do list, my collective life accomplishments still yet ephemerous, need to be fast-tracked. That list cannot be allowed to outlive me, good intentions, or fate deciding.

Perhaps other people spend their autumnal time reflecting on the amassed possessions as some aging dragon in her liar of pillaged treasures? Perhaps not having children to leave a better life to isn't the motivation to dying with assets left behind? Or, perhaps even more disturbingly I recognize my stash will outlive me. I will not be able/chose not to, exhaust it before the timeline draws to a close. Perhaps this is the tipping point? that place where your efforts tip to giving back versus gaining more? Perhaps that's what aging, retirement, exhaustion and a worn out body brings to your peace of mind as the collective cacophony of a chaotic world swirls around you?

My Raffles kitten. She was given up on because her sibling came up positive for rabies.
Four months of quarantine and she is mine.
Life for me works like this. These needful souls find me.
I am as much grateful for them as I am for the fate that brings them to me.

Maybe that's why I am so much happier in the looking back than the drive to accelerate forward?

Oh, that's right, today is Tuesday. I must get dressed and go fight those diseases and dragons for another good day of deeds in the small animal vetmed trenches. I'll rest tomorrow and save a carrot for the slumber another day. 

Raffles watches as Birdie wakes up from her spay surgery.

Tipping points too often get me confused between tipping and pivoting. I don't know if I can recognize one versus the other any longer.

There is a real-life plight in vetmed these days. Those of us who grew up in the trenches, took on a place of our own, led or our community practice for a few decades, sunk our whole lives into. We are at a place now where we have to decide how to exit. Do we take the big cash out from the guys who might as well have a Hamburgler face on. Their shifty eyes, smooth talking and thick gravid unexplained check books? Or, do we try to find some new grad willing to take the reigns and care for the next generation of pets the way our previous generations of vets did? Is that even possible?

Hamburgler holding the American icon hostage

Me, I am at a place where the box has to be rethought, reinvented and repurposed for the greater good and not the singular cash out retirement/burnout plan. Me, I'm pivoting before the tip pulls me under.

Saving The Soul Of Veterinary Medicine by Mark Helfat

 Saving the soul of veterinary medicine

An appeal to practitioners to sustain small, independent clinic ownership

February 15, 2023 (published)

By Mark Helfat

Photo by Scott Nolen

The author, Dr. Mark Helfat, snuggles his dog, Simply Irresistible Giselle.

Last June, I attended my veterinary college reunion (45th!) in Ithaca, New York. Over three days of perfect weather, old memories and old acquaintances were revisited and renewed in all their youth and splendor.

Before, during and since that glorious weekend, I have enjoyed ample opportunity to ponder my veterinary career with all its twists and turns, what-ifs and why-nots. I have spent many moments reflecting on our profession — where it started for me and where I see it now.

It saddens me to conclude that veterinary medicine is quickly losing its soul. I choose this word "soul" because, for me, it denotes a life-sustaining spirit, an inner force of sustenance, a vibrant, glowing core.

For four decades plus, I have viewed veterinary medicine as a singular profession. As practitioners, we treat animals and care for owners. Yes, "we care for owners." Our patients do not arrive on their own. The hand of a human is at the end of a leash or upon the handle of a carrier. Our veterinary-client-patient relationship, our VCPR, relies as much upon the C as it does upon the P. And the C and P don't have a chance of finding fulfillment and the finest care with the V unless a sound foundation of trust has been established.

I rarely encounter the word "trust" when studying veterinary journals, webinars and lectures. How do we establish this fundamental condition as we navigate daily examinations, treatments and client interactions? In my opinion, the sine qua non for gaining trust is forging a personal relationship — a one-on-one, caring, empathetic, honest and human touch.

Where would I look first to discover this foundation of trust; this genuine outreach of caring? With certainty, the answer is the independently owned, smaller-sized, community-based veterinary practice. The life and blood and soul of veterinary medicine lies in the long-established, solo-owner, hometown animal clinic.

So I'm sad to see that these clinics are disappearing, as corporate ownership, investment venture capital and super-sized juggernauts consume and dominate the present and future of our profession.

If you have never worked in a smaller clinic such as mine, allow me to draw a picture:

• The receptionists greet each client and pet by name — because they know their names.
• Clients never wait more than 48 hours for an appointment.
• Emergencies are seen that day.
• Appointment requests for specific veterinarians are gladly accommodated.
• There is frequent conversation in the exam room regarding family and all the accompanying health updates and milestones. There is no shortage of bad and sad news; however, we find the time and we have the concern.

More examples of characteristics from my practice that define the soul:

• The veterinary staff and non-veterinary staff have negligible turnover, with tenures averaging 10 years. More than half of the staff has been in place for 20 years.
• Financial concerns and limits are addressed case-by-case, allowing for discounted care when the pet needs immediate attention. If we know the client, late payments may be arranged.
• We see our patients from youth to euthanasia.
• We see our clients age as children to adults, and then we see their children.
• While appointments are scheduled at 15-minute intervals, they often go over — and we do not mind.
• Callbacks are made the next day for every surgery and for most visits involving sick patients.

I cannot view an episode of All Creatures Great and Small without breaking into tears. Silly, right? But the life depicted in the series — which you probably know is based on books by James Herriot, pen name of a 20th-century British animal doctor — is exactly what our profession is losing. These vignettes of a practice that is a family point straight to the profession's soul.

I do not have a Mrs. Hall who answers the office phone 24/7 and cooks all of our meals but I have loyal employees who genuinely know many of the clients as not just pet owners but as friends. The staff is not just staff. We are a family. Having known each other for so long, we truly care for each other.

Don't get me wrong. A large corporate practice will certainly check some of the boxes above, and I applaud them. However, it is my firm belief that the small, independent practice will check more — if not all — of the boxes.

Beyond the trend of large corporations buying up practices is a newer, and in some ways more terrible, trend: Many baby boomers who own solo, independent, small-town practices are reaching retirement. For various reasons, some younger practice owners also are looking to exit. But they cannot find a buyer for their established, vibrant, profitable practices. I speak to such veterinarians weekly who are now contemplating closing the doors and simply walking away.

I am talking about practices that annually gross $500,000 to $900,000. These practices have for years provided incomes that have purchased homes, paid bills, put kids through college, funded substantial IRAs and 401Ks, paid off student loans and provided a comfortable, happy existence.

At one time, these practices would be in demand. They would have associates eager to buy in. The owners might run an ad, and soon, the phone would ring. Simple word of mouth would send someone inquiring. No longer. Why? There are many theories and many new forces at work, but that is a topic for someone else. As these practices serving both small and large animals close, the impact is widespread and devastating:

• Veterinarians lose funds they had counted on for retirement.
• Longtime staff are left jobless.
• Towns lose a clinic, and the next nearest animal hospital may be far away.
• Clients are forced to start over with a new facility where wait times may be much longer.
• A community loses a pillar.
• Veterinary medicine loses another fiber of its soul.

Disclosure: I am among the veterinarians frustrated in trying to sell my practice. But my individual situation is not the problem. The issue is that this phenomenon is affecting a broad swath of clinics.

Please spare me the discussions of EBITDA, no-load and cash flow. I speak to veterinarians who have great numbers but because of proximity to another clinic, the mood of the broker, the high payroll percentage and a million other excuses, they cannot attract even a serious broker.

Is it too late? I say no!

Organized veterinary medicine has a habit of looking at other medical professions for ideas and answers. On occasion, the dental profession has been inspiring. Regarding this very topic, it lends some hope. Dentists have done a remarkable job of maintaining the noncorporate, smaller-sized, traditional community practice. In fact, they are quite successful at passing on facilities to associates and other buyers as they move into profitable retirement.

Where veterinary medicine now approaches 25% corporate ownership and is projected to rise, dentists in recent years have come in much lower, around 15%, judging from a 2021 article in Dental Products Report.

To drill down further (sorry): The American Dental Association — dentistry's counterpart to our American Veterinary Medical Association — has a formal initiative called ADA Practice Transitions (ADAPT) that addresses preserving the independent and smaller dental office. The program has a step-by-step process by which buyers and sellers are connected. Advisers are provided to facilitate the transitions. Simply put, the ADA has decided to play an active role in preserving the soul of their profession.

Perhaps our AVMA would consider a detailed study of the dental profession's trials and errors with ADAPT. Might such a program be of value for the veterinary profession? The AVMA has 400-plus volunteers from every corner of expertise, a professional staff that is surpassed by none, an Economics Division and even a Veterinary Economics Strategy Committee. I would hope that if our association studied this dental initiative and plugged in the unique characteristics of veterinary medicine, we might, in fact, construct our own program.

Considering the present disaster of our disappearing practices, I imagine that an AVMA counterpart of ADAPT could offer significant incentives to encourage and attract reluctant prospective buyers. Among such incentives, I'd suggest including the following:

• discounted sale prices (would a retiring practice owner jump at receiving 80% of practice value compared with nothing?)
• the option of a personal loan carried by the seller, with a minimal required down payment
• providing a list of reputable lenders willing to consider providing the necessary financing
• no commissions for either party (but presumably some type of service fee collected for the association)
• advisers for both parties
• a discussion with the seller of practice management options
• a program in which a prospective buyer first works at the practice alongside the owner and later buys in, either over a period of time or in whole

I would be foolish not to admit that there are impressive benefits that accompany employment at a large corporate facility:

• flexible schedule
• good pay
• health insurance
• paid vacation
• ample continuing education
• mentoring
• human resources support
• fancy, state-of-the-art equipment (read "MRI")

But all of these are standard fare for a practice owner, with the exception of the MRI. Do we all need the MRI?

Here are the benefits of independent ownership:

• being your own boss
• running a profitable business
• holding a recession-proof job
• more wealth
• paying down student debt more quickly
• creating tangible equity
• choosing your own schedule
• hiring family
• amassing a sizable IRA/401K
• becoming a community partner
• mental well-being derived from personal stability and achievement
• saving the soul of veterinary medicine

I was an associate veterinarian for six years. I have been an owner for four decades. I am much happier being an owner! I wonder how many years I would have stayed full-time in the profession had I remained an associate. Certainly not more than 20 or 25 years. And would I have found the success, stability and well-being that I now enjoy?

We are all different, and others' answers to this question will vary. However, I am not alone in lauding the advantages of ownership.

When will veterinary medicine reach its tipping point with regard to corporate ownership? If our profession continues on its present course, we may never see small private ownership again. Without new blood, our soul will slip away, never to be seen again. Just look at our friends in human medicine and their overwhelming corporatization. I contend that they lost their soul a long, long time ago.

One question to which I have no definitive answer is, "How many associate veterinarians have ever seriously considered practice ownership?" If one considers that the AVMA boasts 100,000 members, let's say that 75% are in general practice. That would give us approximately 75,000 veterinarians in general practice. If just 10% are youthful associates who have considered practice ownership, that is a sizable population that we must encourage and support.

Here is my elevator speech to our future, the saviors of our soul:

• Talk to your accountant/financial adviser about practice ownership and its benefits for you.
• Talk to some practice owners, classmates and friends in practice about the benefits of practice ownership.
• If you work at a noncorporate practice, consult the owner about the possibility of buying in.
• Reach out to the "maturing" veterinarians in your town, in your county, in your state. Ask what their exit plan might be. Don't be shy. You might gain some new friends fast.
• Attend your local and state veterinary medical association meetings and spread the word that ownership is in your future planning.
• Don't forget the drug reps as a source for who is looking to sell. They know everyone.

When I finished 15 years of volunteer service on the AVMA House of Delegates and Board of Directors, I promised myself two projects on behalf of the profession: First, write an inspiring book for veterinarians of all ages. That was easy. Within a year, I scribbled down The Happy Veterinarian. Second, and a whole lot more difficult, start a nonprofit that serves to save the soul of veterinary medicine. I founded Veterinary Practice Transition in 2020.

The mission of the organization is to encourage younger veterinarians to consider practice ownership while providing the older generation an option for selling their practice. The nonprofit offers personal loans with low interest rates, a 10% reduction/discount in the sale price, and no commissions for either seller or buyer. The effort is a work in progress. I cannot succeed alone. The profession as a whole needs to address the impending doom.

In closing, let me return to my reunion. As my classmates of '77 gathered and regaled each other with tales of conquest, I saw the immense, reflected energy of careers that served them all so well, but even more, careers that served so many others with compassion and empathy. What I also observed were veterinarians who reached out as family and friend, fostering the trust that defines the soul of our profession.

Mark P. Helfat graduated from Cornell University College of Veterinary Medicine in 1977. He owns and practices at Larchmont Animal Hospital in Mt. Laurel, New Jersey. He has volunteered for veterinary organizations and institutions for most of his career (New Jersey Veterinary Medical Association, American Veterinary Medical Association, Cornell University College of Veterinary Medicine, Virginia-Maryland College of Veterinary Medicine). Mark and his wife, Mendy, commissioned the sculpture "Shilo" that howls on the Virginia-Maryland College of Veterinary Medicine campus. The couple share their home with four beagles and many cats.

Cheers to you Dr Helfat. Here's to the rest of us working so hard to preserve the many souls vetmed is built upon.

Hello 2022, Whatcha Got Up Your Sleeve?

It's the dawning of a New Year, and, hope springs eternal, again!

(yada, yada).. as we all try to shake loose of this pandemic. Time to look back as I plan ahead. 

Or, as I feel is more realistic.., what couldn't go right from here?

So, here it goes,, pen to paper, heart on my sleeve, best attempt at optimism to carry me through another year. (Roaring 20's comin' round again?)

I want to open this new year full of old hopes and new dreams.... 

This year I am making some lofty goals. It's a combination of feeling obligated to make resolutions for a brighter future, and, be reminded about the bleak recent past.

Here's the dilemma..

I have this nagging lingering insecurity that I am going to find my dear friend Havahs' fate. She died in 2020 at 47. She was also a veterinarian, and a veterinary practice owner. She had two kids under 10. Or, my mom who died at 74 thinking she still had another 74 years left to get her dress rehearsal right. They both died too young. They both thought they had more time. Turns out life will hand you a shit sandwich and then watch you die trying to accept it. I prefer to not have any of this nonsense. I much prefer to die old, tired, contented and meeting that new book of the afterlife with a smile of gratitude and the look of the cat who swallowed the canary glee on my face. I hope to get away with everything as I accomplish more than imaginable. Maybe that’s not relatable to anyone? Maybe, in your opinion 47, and 74, are ripe old ages and there are too many people on this planet anyway? But, if COVID has driven home one thing it is that life is short, fleeting, unpredictable, and disposable. A bug/virus can rule the world and keep us hostage while it permeates every corner of every human life. Fear shouldn’t be the only motivator, but it makes a damn good coach.

There isn't much that my life is without. I seem to have so much that I wonder where it all belongs at times? It's a comfortable nest of fluff and fodder that I made for myself. Just enough dogs (two, and they are inseparably happy together), three house cats (and they have found a way of avoiding each other just enough to no longer have cat fights), my two clinic cats (Seraphina, she's famous, (see my Jarrettsville Vet Facebook page if you don't believe me) and Oreo, her ever devoted side-kick), and, the amazing group of people who keep the inner soul of the vet clinic burning bright. I seriously fear that way too many vet hospital owners claim success based on the thunderous magic of their worker bees who keep their practices alive. It's tragic and pervasive. I don't subscribe to it. I might pick the paint colors, and pay the mortgage but JVC is the magical kingdom of hope and miracles because of it's people. I have just enough, and yet there is this relentless nagging that I can do more. Maybe not for me, but others. That place where inner calling supersedes personal preferences to the laurels and my nest they lie upon.

I was talking to an old friend who now hosts a podcast on "successful veterinary practices" (of which JVC seemed to qualify based on metrics that remain mysterious to me). He asked me how the pandemic had changed the way I manage the clinic? I told him that I will never be the same on the other side of it. Early on, when the world was closing down to a hide-away halt, I told myself that no matter how bad this pandemic got I was not going to be the person who failed JVC. I am the third owner of a place that has survived and served its community for over 80 years. I have their legacy to carry and preserve. If that meant I would have to sleep on a cot, work any hour of the day needed, answer every call for help regardless of its severity, I would. I was prepared to be the vet of one against the pandemic of all. Whatever it required I would not let this clinic fall or fail. I was not going to succumb to the fear. The virus might claim me, and I might be one of those little ones in the litter of parvo pups where you are the single one who will survive. I had seen infectious disease wipe out populations before. I knew this villain, but, I wasn't hiding and surrendering. At this same time my mother was bedridden at her home battling a demon of her own. She lost her battle to cancer quickly in the beginning months of this world wide quarantine and fear. Her fear wasn't all she had to shoulder, she focused on the worlds of panic, tucked herself away, and gave up without ever fighting. It was the darkest hours of my life, without question.

Through that loss the clinic chugged along. In the beginning we lost some staff due to personal preferences about exposure and family obligations. As our numbers dwindled so to did the demands for routine care. It was a symbiotic relationship that made life manageable. But through these early days I had this burdened heart that was unshakable. Fear. Dread. Despair lurking. I got through it reminding myself that "to each beginning there is an end." One step, one day at a time. Breathe. Be brave. It's all I could do. 2020 took two lives very close to me. 2021 was the mourning dark veil of a still life still frozen in COVID paralysis.

At a vet conference mid Summer 2021, mid pandemic, I met with other female practice owners. We were all grateful for a get-away, and, we were all exhausted. Most of us qualified as 'burnt out,' I was charred. What I wasn't expecting was how much their attitudes about their practices had changed because of COVID. All, and I do mean all, were once (pre-COVID) worried about how the new corporate ownership would affect their staff. Two years prior I would have said that this was the biggest and most significant factor swaying practice owners to not sell to corporate. That concern had evaporated. Their viewpoint now was exactly what the corporate acquisitioners wanted to hear; "I'm too tired, too broken, and too frustrated/fed up to care anymore about anyone else. I just want out."

I never got there, but, I understand how others did. Had I been forced to run the clinic solo I am not sure I wouldn't have crumbled. I know of one veterinarian who lost 9 of her 11 vets in the first few months of COVID. They left for many reasons, but, they also left her largely incapable of meeting the demand. When I asked her how she did it she replied that the techs did everything. She stayed in surgical scrubs all day and the techs did everything else. It was now 9 months later and she was selling. Her team had abandoned her in her darkest hours of need. 

The backside of this pandemic has left me feeling relieved of a burdened heart that couldn't have taken much more. Where early on the demand for services was so great we were stretched thin to meet them, now we are anxious for its departure. COVID vaccines are available to anyone who wants them. Where I had feared people would be putting themselves at significant risk to stay employed with us, they now had options to protect themselves more than the mask and PPE's, (which make medicine inherently more difficult to patients who cannot talk to you), could. If a staff member had gotten exposed at work, brought that home and infected others, and anyone had died along the way the guilt would have crippled me. I was out of that self-imposed fearful scenario by end of 2021. The burden was now solely and singularly on them.  I could go back to being grateful for their help and not burdened by the fear of their presence.

Maybe being able to forge your path from the end is a good way to not be hesitant or afraid of the now? Maybe as I live everyday with such a constant reminder of what we are all going to lose from living through this, is a way to be more free to make huge mistakes, take huge risks, and live without caring about what others judge, call, label or even think about me.

I can say with a full belly of castigation that almost everyone who is anyone in vet med thinks I am an awful person. From the vet side my colleagues hate me. Yep, hate. Such a cruel word. I am not on twitter anymore and I cannot use the Facebook peer pages without at least one veterinarian trying to berate, bully and intimidate me into hiding in shame. I am outspoken. I remain this way. And it compels my every move in vet med. We, this profession, have failed so many pet parents whose lives revolve around their companions. The prices, expectations, and yes, our own interactions with pet parents is decaying. Vets don't seem to care as much as we believe we portray ourselves to the public. Too often in this, my own clinic, if I try to be vegetarian I am faced with the same shaming and ridicule. As if this life choice is insignificant and banal. And this is from people I actually care about. As I try to be kind to all animals I have staff members insulting me and mocking me. That hurts. I remind myself of this as I try, (operative word), try, to be respectful that others have different opinions. Even opinions on COVID vaccinations. I have had to accept that they may get sick, or even die, and it was their choice. I can almost accept this, except for one small thing, that person could infect another person who might not survive. So I try to be respectful of civil liberties and freedoms in the face of vulnerable defenselessness and yet I struggle to elevate them to the place of pride and dependency they hold.

I have done all I can do as a leader in a small town with a vet clinic that has no equal. We are the sum of all of our parts and yet we are still here facing another year of undoubted challenges with unknown obstacles and a big heart on our sleeve which I will be the first to say is our biggest strength for our greatest chances at success.

We survived the pandemic. What has it done to me? I suppose it will take 2022 to see? 

We were so lucky.

That fact has brought me back to being able to set goals. Make wishes. Be at peace.

What had gotten us here? I think it was just being true to who we are. Not being reluctant to be genuine. And staying there for them in both of our darkest hours.

How do these fit into this book of my life? My singular narrative?

I am left with feeling that they are the root of everything in life. 

Here's to all of us finding a new dawn in a new year, and the hopes that dreams are still possible on the other side of gratitude that we are all still here.