By Patty Khuly, VMD, MBA
Published in partnership with Veterinary Practice News
Veterinary medicine has grown remarkably adept at articulating its loftiest ideals. Walk into any continuing education conference, flip through an academic journal, or listen to a hospital recruitment pitch, and you will hear a familiar, polished lexicon. We champion evidence-based medicine. We wave the banner of One Health. We nod solemnly at antimicrobial stewardship, client-centered communication, the spectrum of care, the diversity of voices, and independent clinical judgment.
Yet, beneath this rhetorical veneer lies a stark, uncomfortable truth: we are often far less accomplished at actually executing these principles than we care to admit.
This is not intended to serve as yet another exhaustive catalog of the profession’s systemic sins. Veterinary medicine has no shortage of critics eager to point out what is broken—a group this author has occasionally joined. Instead, consider this an operational roadmap. It is a curated list of things we already know how to do, operational tools already at our disposal, and behaviors we could fundamentally alter tomorrow if we could simply get out of our own way long enough to think critically.
Executive Overview
The modern veterinary profession finds itself at a profound crossroads. Beset by external pressures—ranging from aggressive corporate consolidation and inflation to crushing student debt, workforce shortages, rising consumer costs, and widespread practitioner burnout—it is easy to feel like a passenger on a runaway train. We spend countless hours discussing the macro-forces acting upon us.
However, this inward-looking analysis often obscures the agency we willingly surrender. By clinging to outdated habits, hiding behind rigid hospital policies, abdicating our leadership roles, bowing to antiquated hierarchies, and retreating from business ownership, veterinarians are actively ceding control of their own destiny.
Reclaiming the profession does not require waiting for macroeconomic recovery, sweeping legislative reform, or a cultural reset from external stakeholders. It requires confronting six internal self-sabotaging behaviors and systematically dismantling them.
Detailed Chronology: How Veterinary Practice Lost Its Way
To understand how modern practice drifted from its core values, we must examine the incremental shifts in education, corporate influence, and workplace culture over the past several decades.
The Accumulation of Reflexive Habits
Veterinary training is, by necessity, a process of heavy cognitive loading. Schools teach students how to process vast amounts of pathophysiology, pharmacology, and surgical technique under extreme pressure. Consequently, the curriculum emphasizes the acquisition of established knowledge.
However, professional practice demands something vastly more difficult: the continuous, uncomfortable process of unlearning. Over time, clinical routines solidify into unquestioned dogmas. Practitioners reach for specific broad-spectrum antibiotics or order standard diagnostic panels out of reflex rather than critical evaluation. Over decades, these unexamined habits calcify into standard operating procedures, separating daily clinical reality from the very evidence-based medicine we profess to practice.
The Rise of Corporate Standardization and Policy Creep
Concurrently, the rapid consolidation of veterinary practices—accelerated by private equity investment—has introduced standardized corporate policies designed to maximize efficiency and mitigate liability. While uniformity can streamline operations, it frequently strips frontline practitioners of their individual clinical judgment.
Hospital protocols designed to protect the bottom line or streamline front-desk workflow have inadvertently replaced human empathy and medical nuance. The moment an administrative checklist takes precedence over a nuanced conversation between a veterinarian and a pet owner, the profession loses a piece of its soul.
The Retreat from Civic and Professional Governance
As clinical workloads intensified over the last twenty years, individual practitioners increasingly retreated from local, state, and national veterinary medical associations. Viewing these organizations as distant bureaucracies, grassroots veterinarians stopped attending meetings, sitting on committees, and running for leadership roles.
This vacuum did not remain empty. Into it stepped corporate entities and individuals with commercial interests that only partially overlap with those of everyday practitioners. By outsourcing professional governance, veterinarians allowed external stakeholders to draft the rules governing telemedicine, technician scopes of practice, controlled substances, and the veterinary-client-patient relationship (VCPR).
Supporting Context & Metrics: The Cost of Complacency
The consequences of our professional self-sabotage manifest across six distinct operational domains.
1. Stopping What We Know We Shouldn’t Be Doing
Let us start with the lowest-hanging fruit: antimicrobial stewardship. We pride ourselves on our One Health mindset—recognizing the interconnectedness of human, animal, and environmental health—yet many practitioners do not blink an eye when prescribing doxycycline to virtually every kennel-cough patient that walks through the door. We reach reflexively for metronidazole in dogs presenting with uncomplicated acute diarrhea. Across the globe, a cat with dysuria is likely receiving cefovecin injections or heading home with amoxicillin and clavulanate potassium without a urinalysis.
The guidelines are no longer ambiguous. Yet, antimicrobial stewardship frequently devolves into a hollow slogan: "Culture when convenient, prescribe when not."
Similarly, consider diagnostic overreach. Why do we routinely order comprehensive diagnostics on "standard executive panels" when we know—if we paused to consider the individual case—that the results will not alter our therapeutic plan? Ironic, isn’t it, that clinicians frequently skip one or two inexpensive, highly targeted tests that could entirely pivot our diagnostic approach, usually because we have already blown the client’s diagnostic budget on a pricey, cookie-cutter corporate panel?
2. Making "Spectrum of Care" a Reality, Not a Catchphrase
While the profession is getting better at acknowledging that there is rarely just one medically acceptable way to treat a patient, our hospital workflows have failed to keep pace.
Consider the typical exam room dynamic: We invest physical, intellectual, and emotional capital diagnosing a case, formulating an ideal plan, and building rapport. Then, we abruptly step out, leaving a technician to "go over the estimate." When the client experiences sticker shock, gets overwhelmed by the dancing numbers, and declines half the plan, a receptionist hands them an Against Medical Advice (AMA) form at the front desk.
Where was the veterinarian during the most critical medical decision of the visit?
Deciding what can safely be removed from Plan A to create a medically defensible Plan B—or C—is the practice of medicine. It requires medical prioritization. It is not a receptionist’s job; it is not even primarily a technician’s job. It is the core duty of the licensed veterinarian. Slapping an AMA signature on a frightened client’s chart is an administrative cop-out, not healthcare.
3. Ending the Outsourcing of Our Professional Future
Most veterinarians do not belong to their local or regional VMAs. Fewer still engage with state legislatures, communicate with veterinary boards, or seek leadership positions within national bodies.
When we abandon the room where decisions are made, other voices fill the void. Increasingly, those voices belong to corporate conglomerates and private equity representatives whose primary fiduciary duty is to shareholders, not patients or practitioners. When veterinarians complain about corporate overreach while refusing to show up to organizational meetings, the irony is palpable. Leadership requires presence.
4. Dismantling Unhealthy Hierarchies
Veterinary medicine remains shackled to an antiquated, rigid hierarchy:
- Young veterinarians defer blindly to older colleagues.
- Associates defer to practice owners and medical directors.
- Interns defer to residents, and residents to specialists.
- General practitioners defer to specialists, even when managing a chronic case for over a decade that the specialist only sees episodically.
Expertise is vital, but seniority is not synonymous with expertise. Neither is practice ownership or administrative title. Young practitioners must be trained not merely in passive mentorship, but in professional, assertive discourse. Disagreeing constructively with a medical director, challenging a corporate protocol, or questioning a published recommendation is not insubordination; it is intellectual rigor.
5. Embracing Practice Ownership
Far too many veterinarians have convinced themselves that while they are capable of mastering complex acid-base physiology, anesthetizing a sixteen-year-old cardiac-compromised Chihuahua, and resecting an intestinal foreign body at 2:00 a.m., they are somehow "too right-brained" to understand a Profit and Loss (P&L) statement.
Business acumen is not an inherited genetic trait; it is a learnable, mechanical skill. Furthermore, practice ownership does not require constructing a gleaming, multi-million-dollar hospital from the ground up. It can involve acquiring a quiet, single-doctor practice that nobody else wants, launching a mobile veterinary service, establishing a feline-exclusive clinic, entering a partnership, or buying equity in your current workplace.
Ownership confers essential power. The fewer veterinarians who own veterinary enterprises, the fewer veterinarians steer the future of the entire industry.
Official Statements & Industry Perspectives
The internal friction plaguing veterinary medicine has not gone unnoticed by organizational leaders. Navigating the delicate balance between corporate-backed efficiency and clinical autonomy remains a primary challenge for modern veterinary associations.
Industry observers note that while corporate consolidation has provided much-needed capital infusion to modernize aging facilities and improve staff compensation, it has concurrently alienated practitioners who entered the field for clinical autonomy.
Furthermore, educational leaders emphasize a growing push to integrate business fundamentals and communication frameworks directly into veterinary doctorates. The goal is to produce graduates who possess not only surgical and diagnostic competency, but also the self-advocacy skills required to navigate complex organizational structures without burning out.
Future Outlook: Reclaiming Our Agency
Every challenge explored in this analysis shares a single, underlying common denominator: the surrender of professional agency.
- Prescribing metronidazole out of habit is surrendering agency to routine.
- Handing a bewildered client an AMA form because "it’s hospital policy" is surrendering agency to bureaucracy.
- Letting corporate representatives populate VMA committees is surrendering agency to commercial interests.
- Staying silent because you are a junior associate is surrendering agency to seniority.
- Declaring yourself "incapable of business" is surrendering agency before stepping onto the field.
Veterinary medicine is undeniably navigating a turbulent era marked by consolidation, inflation, student debt, and client volatility. These pressures are real, measurable, and challenging. However, we must stop fixating exclusively on external forces that lie beyond our control, and instead redirect our energy toward the vast domain of practice that remains stubbornly within our grasp.
The future of veterinary medicine will not be written by private equity firms, algorithmic software, or disgruntled online reviews. It will be written by the practitioners who decide to show up, speak up, think critically, and take ownership of their profession.
Dr. Patty Khuly, VMD, MBA, is a practicing small animal veterinarian in Miami, Florida, and operates drpattykhuly.com. The opinions expressed in this column are her own and do not necessarily reflect the official stances or editorial positions of Veterinary Practice News.
