money matters: make your peace between profit and charity in practice
“You care more about my money than my pet!”
“I wish you could be my doctor.”
In my 25 years of veterinary practice, I’ve heard those words on countless occasions, sometimes from the same client. Those sentiments highlight the struggle we have within our profession: Why do veterinarians have an agonizing association with money? Where do we draw the line between profit and compassion? How can we do good for animal welfare while doing well financially in our practices? The answers may be both simpler and more complicated than you think.
How did we get in this mess?
Veterinarians were revered in ancient times because we cared for our tribe’s food animals. Our roots intertwined with commerce as livestock attained economic value. During the previous 200 years, the limits on our compensation became based on the “replacement cost” of the animal. In other words, we could only charge commensurate to the value of the patient we were treating.
The limitation on our fees had the unintended consequence of hampering primary medical progress in veterinary science. For most of modern veterinary medicine’s history, we’ve been consigned to scrounging for human medical research scraps. It’s only been in the past 50 years that major pharmaceutical companies have recognized animal health as a profitable sector worthy of their resources. And that gets to the real reason of how we got in the mess.
Our Limiting Legacy
It wasn’t until the 1970s that small animal veterinary medicine as we know it today came into existence. Prior to that, a farm-call veterinarian would administer the occasional vaccine or offer basic treatment for a dog or cat. Why? Because there wasn’t any inherent financial value in pets. The farmer could justify spending $50 on a cow he could sell or milk but not on a dog with a broken leg. While his family dearly loved the dog, he just couldn't rationalize paying much for treatment.
It was in this environment that early small animal veterinarians established the money-guilt we experience today. The first pricing schedules were grounded in the legacy of “replacement cost” and arbitrary mark-ups based on what veterinarians thought clients would pay. Feeling uncomfortable raising their fees for examinations and professional services (it was only a cat, after all), many veterinarians expanded their offerings into areas they weren’t entirely at-ease. The battle between “selling” and “serving” commenced. There were a multitude of paths our profession could’ve, and probably should’ve, chosen to elude our current quandary. Despite all of this, I believe part of our predicament can be traced back a few more decades to a beloved icon.
Blame it on Dr. Herriot?
I also blame James Herriot for our profession’s money-guilt. Herriot set the “veterinary virtuosity bar” unreachable by most of us by accepting a few eggs in exchange for years of specialized education, investing in expensive equipment and medications, driving in dangerous conditions, leaving our families and then staying up all night curing an ailing animal. I can’t match that. Many veterinarians swayed by his chivalry cringe when conversing about currency for our services. “That’s okay, a handful of eggs will be sufficient.” His memoir, “It Shouldn’t Happen to a Vet,” takes on an entirely new meaning now, doesn’t it?
We carry this ethos in our DNA today. Even as pets have risen in prominence and incomes allowed owners to demand high-tech tests and treatments, we still harbor hesitancy about money. Some of our colleagues consider anything more than a few eggs too much to charge. Others are convinced that financially successful veterinarians are greedy, uncaring or probably both. In my experience, there’s room for both eggs and elitism in the veterinary profession.
Making Peace with Profit and Philanthropy
Businesses exist to produce profit. As long as an enterprise pursues profit in an ethical manner, making money can benefit society. For example, if my practice revenue grows, I am able to hire additional staff members and pay a fair wage, invest in helpful technology and give back to my community. Or not, if I’m a greedy louse. I can’t do either if my practice isn’t profitable.
In the debate of should veterinarians do more… (fill in the blank with the cause of your choice), I typically say, “Yes!” I say this because we should be doing more. More community outreach and involvement, more political engagement and more personal development. In my experience, the best businesspeople aren’t greedy, they’re giving. Most truly successful people I know understand to sustain success they must invest in their staff, contribute to their neighborhoods and retain high standards, ethics and morals. I’m incredibly proud to call myself a veterinarian and just as proud of my entrepreneurial accomplishments.
Roadmap to Peaceful Prosperity
The first step toward reconciling the pull between wealth and charity is to define yourself and your practice objectives. What does it mean to be a veterinarian to you? What are your metrics for personal and practice success? How do you know if you’re achieving your goals? Too often we allow others to determine who we are and how we practice. This creates tension, frustration and, ultimately, disillusion. Burnout is the result of dissatisfaction with an undefined journey.
Self-reflection is essential because I feel most money-guilt is anchored in poor professional self-confidence. Blame it on our history, the economy or perhaps James Herriot. The fact remains that many veterinarians would rather swig anal gland juice than talk about money with clients. Maybe it’s because I started my first practice without any full-time employees in a poor, rural setting, but I became comfortable looking clients in the eye, telling them how much money they owed me, and saying, “Thank you.” I became “money-calm” because I’m convinced I provide a valuable service. That’s not arrogance; that’s self-confidence and it can help you relax around remuneration.
The next step is giving back. I’ve always focused on one or two major fundraisers for my clinics each year. Most of our philanthropy involves animal and children’s charities. We also created a fund within our business to raise monies to aid financially distressed families with their veterinary bills. I’ve discovered that whenever your staff witnesses you giving back to charities and needy clients, they’re better handling the inevitable, “All you want is my money!” complaints.
Inserting yourself into animal welfare issues is another stride toward being proud of your profit. One of the chief responsibilities of success is applying your influence to causes you’re passionate about. Being financially fruitful often opens opportunities for change you’d never access from the cheap seats. Movements and charities need disciplined, ambitious and bold leaders. These attributes are most often associated with successful businesspeople. Use your power to fight for better treatment of animals.
Falling Off the Tightrope
Treading this tightrope isn’t easy. I can’t adequately explain nor resolve this issue in a few hundred words. Clients will still say ugly things to you and about you, and stress doesn’t evaporate overnight. You’re going to want to quit and take the eggs. Don’t. Not only is our profession counting on you, your career and happiness are at stake. It gets better the more confident you become. Absolving yourself from the guilt of receiving money for your expertise is crucial for professional peace of mind. Self-confidence helps shield you from the sting of criticisms and allows you to develop into the veterinarian you dreamed of being.
For that, I thank Dr. Herriot. His writings shaped who I am today and instilled in me the power and sanctity of the human-animal bond. It’s up to each of us to turn yesterday’s basket of eggs into today’s credit cards and cash. Perhaps no other profession can do as much good while doing well. I’m proud to work alongside some of the most caring, compassionate and selfless folks in the world – veterinary healthcare providers!
This article originally appeared in the UK’s Veterinary Business Journal.