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President's Message: The CVMA and Veterinary Practice Networks

May 12, 2025

Does the Canadian Veterinary Medical Association (CVMA) have a role with regard to the Corporatization of Veterinary Medicine?

In January, the Canadian Broadcasting Company (CBC) broadcast 2 exposés informing the public that some members of the profession were very concerned about management decisions made by the Veterinary Practice Networks (VPNs), also referred as corporate-owned veterinary practices, they worked for, implying that profit instead of patient welfare was now the goal of our profession.

A recent ethical question of the month published in The Canadian Veterinary Journal implied that VPNs were the root cause of decreased competition and increased prices. The article also suggested that veterinarians working for VPNs were facing pressures to generate more income to satisfy shareholder demands and were being forced to place shareholder needs ahead of their clients’ needs.

Since CVMA is the national voice of veterinarians and has mandated itself to support the membership, what part, if any, does it have to play regarding the corporatization of veterinary medicine? Does it have a different role when talking to the public than when talking to members? Is the growth of VPNs just the natural progression of the profession, much like we have seen in dentistry and pharmacy, or should the profession be taking an active role in our future? Is CVMA involvement tempered by the fact that it is not a regulatory body?

I will begin by stating that the following are my thoughts and not a reflection of the CVMA as an association. My hope is to start an open and informed discussion about what your national association should be doing, if anything.

The CBC and the veterinarians they interviewed raised the issues of Profit above Compassion, Excessive pricing, Production targets for employees, upselling, and monopolization of services/lack of competition. To those I will add, the inability of veterinarians to compete with equity funds when trying to purchase a facility.

PROFIT VERSUS COMPASSION
Having worked in this industry for over 40 years it is very clear in my mind that the overwhelming majority of membership place compassion well before profit. Yes, bills have to be paid, wages need to be earned, facilities need to remain open, and equipment needs to be updated but your average veterinarian still places the health of the patient first on the list of priorities.

Should CVMA be reaching out to the public to confirm that we still care? Should we be explaining why veterinary medicine has become more expensive? Should we let the public know the average salary (veterinarian and technologist/ technician) and hopefully show that we lag behind other medical professionals? Should CVMA explain that we all compete with each other and have different pricing structures? Should we explain that the veterinarian they are working with may not have the ability to set or to alter pricing? Should CVMA get involved in the argument about facilities having to declare who the owner is? Should we explain to the public the link between mental health issues in our profession and the economic realities we face every day?

PRODUCTION TARGETS
I have mixed feelings about this criticism of VPNs. Average client transactions, number of cases seen, total gross billings, and units of product sold have been part of the toolbox of management consultants and put into use by owners of facilities long before investment funds started looking at veterinary medicine. That being said, production targets need to be reasonable, attainable, and to not lead to the upselling of unnecessary procedures or products. I can empathize with a veterinarian who is told by management that they need to increase their billings to support their wage, especially if they are practicing quality medicine and working as hard as they feel they are able. CVMA’s economic surveys can give approximate gross production numbers needed to support a certain salary, but every facility is different, so these are unfortunately only approximate numbers. I would appreciate suggestions as to what work CVMA could do under this heading.

UPSELLING
The argument about the need for wellness testing for juvenile animals, pre-anesthetic blood work for young patients, heartworm tests for patients using preventative medicines, extensive blood panels versus more targeted profiles are not new in our industry. I think that we all agree that selling additional items for no reason other than to increase production numbers is morally wrong. However, I think we can also agree that what is upselling to one veterinarian may be gold standard and justified to the next member. I think that CVMA might have a role here. 

The public facing side of CVMA could initiate a discussion with the public, empowering them to ask questions, ask for quotes, and to gather whatever information they need to make an educated decision. Informing the public that asking for second opinions should not harm the Veterinarian-Client-Patient Relationship (VCPR) and they should discuss economic limitations and push for treatment plans that they can afford. In short, to feel part of the team.

The member-facing side of CVMA might wish to get more forceful supporting the Spectrum of Care, to make it “the norm” and not just a response to a client’s economic concerns. To work with the governing bodies to ensure that members know that the gold standard is not the only approach to a case and that informed client consent is the new gold standard. The CVMA might also want to discuss with membership that the Spectrum of Care doesn’t just apply to ill patients. Clients can only accept what the veterinarian offers and so maybe we need to let members know that offering wellness blood and heartworm tests along with a personal opinion about their need or relevance is also part of spectrum of care. Should CVMA work in collaboration with provincial veterinary medical associations, to ensure that regulatory policies address the rise of corporate ownership, and that veterinarians are not forced into situations in which they have to compromise their ethics to satisfy corporate pressures?

FINANCING COSTS
The inability of an individual or small groups of veterinarians to compete with a VPN when trying to purchase an existing facility is an unfortunate reality. Big banks have different rules than private equity firms when it comes to loaning money to purchase a professional business. The CVMA can lobby the banks to try and even this playing field, but I would be dubious about our success. Should we reach out to the governing bodies and ask for policies to be developed that address the issues of monopolization of services and decreased competition before a provincial government decides to tackle this issue?

EXCESSIVE PRICING
This has been frequently mentioned as a reality at VPN facilities. Currently CVMA has no data to support this suggestion because economic surveys are always randomized to encourage owners to submit data. I did a literature search hoping that maybe there was some information from south of the border or from Europe, where VPNs have been in existence much longer then in Canada, but could find nothing other than anecdotal evidence.

CONCLUSION
In my opinion, CVMA needs to have an essential role in navigating the complex issue of corporatization within veterinary medicine. Although corporate ownership of veterinary practices has brought some benefits, such as expanded resources and improved infrastructure, it has also raised important questions about ethics and the professional well-being of veterinarians. Through advocacy, policy development, and support for veterinarians, CVMA needs to strive to ensure the profession remains focused on animal welfare and veterinary practices — whether corporate or not — adhere to the highest standards of compassionate care.

I am very interested in your comments and suggestions; please send me an email at cvmapresident@cvma-acmv.org.

– Tim Arthur