Veterinary schools and satellite clinics

Recently I read an interesting article on the establishment of satellite clinics by veterinary schools (1). The case is made that the schools have been turning to private practice to generate revenue and improve their access to cases. An important issue in this development is the concern of local practitioners who feel they may be adversely affected. The author refers to the path taken by the College of Veterinary Medicine at Kansas State University. The dean of the College is cited as saying that about 20 years ago they began to see a decline in caseload, coincident with the emergence of specialty practices and were concerned that, with continued growth in these practices, students would have insufficient case material. The College investigated establishing a specialty practice in Wichita, Kansas, but discontinued their exploration when local practitioners (their alumni) expressed concerns. Fortunately, veterinarians in Omaha, Nebraska, were interested and Omaha became the new target site. A not-for-profit organization was set up to build and operate the hospital and about 5 years ago the college opened a specialty hospital in Omaha. Its development appears to have proceeded in close co-operation with local veterinarians. The hospital offers an elective rotation to students and the dean stated that the main purpose of the hospital was as a teaching resource.

Things appear to be somewhat different at Ohio State University, where one purpose of a recently opened Ohio State University Veterinary Medical Center (VMC) in Dublin, Ohio, is said to be to make money (2). The senior academic administrators see the facility as a bold, innovative step that offers expanded opportunity for learning, increased access for clients, and enhancement of discovery through clinical trials, as well as a means of generating revenue to support the academic enterprise. The 10 000 square-foot hospital is managed by Veterinary Specialty Management, which is reported to have bought the building for $840 000, with the university paying rent in a lease-to-own agreement (3). The company is paid a flat fee initially and later a percent of revenue and bonuses related to profit. There has been considerable debate among Ohio State alumni about the new satellite clinic (2). Some alumni in the area and extending for hundreds of miles have expressed concern; they were unaware of the plans for the hospital until it was built and they believe that the name brand plus the use of low interest loans from bonds constitute unfair competition. They also note that the hospital will be used merely to offer an elective rotation to students. There are others who believe that there is sufficient business for all, the concerns will soon go away, and practitioners should understand the financial pressures on the College.

Interestingly, a 20 000 square-foot satellite hospital built by Cornell University in Stamford, Connecticut in 2011 is also for-profit. Student involvement is restricted to observation, out of a concern for the negative impact on the client experience when hands-on work by students slows up the process. Cornell claims to not compete with local veterinarians and to have put to rest fears and hostility expressed by local veterinarians at the start of the project. Cornell University Veterinary Specialists describes itself as the largest university-affiliated veterinary referral center in the United States, and proclaims that it combines the best of academia and the best of private specialty practice (4). Their mission includes continuing education for the community.

A number of other veterinary schools in the United States have opened satellite hospitals in recent years. The UC Davis School of Veterinary Medicine opened the UC Veterinary Medical Center, San Diego, in cooperation with UC San Diego Health Sciences, and animal institutes of the San Diego region. The University of Florida veterinary school in Gainesville opened Pet Emergency Treatment Services in Ocala. The University of Illinois in Urbana established the Chicago Animal ER Veterinary Hospital in 2011. In 2010, Washington State University in Pullman developed The Veterinary Specialty Teaching Clinic, a 10 000 square-foot satellite facility to supplement veterinary clinical teaching.

It is evident that veterinary schools are reacting to pressures of financial constraint and case load. Financial constraints are associated with restrictions on increases in tuition fees, reduced government funding, and the challenges in fundraising from the private sector in a difficult economy. Different approaches are being taken by the various schools. Perhaps the distinction between for-profit and not-for-profit is not as great as it might seem at first, as any profit made by the not-for-profit organization is ploughed back into the “business.” The same thing occurs with the for-profit. However, the fact that the for-profit organizations have severely restricted student involvement is concerning. The Kansas State experience indicates that doing it right takes considerable time and involvement of local practitioners. It is possible to have a win-win situation that works well for veterinary schools and practitioners.