The future of independent practice

RE: The future of independent practice

Francisco Gomez — Mon, 06 Aug 2018 17:56:13 GMT

[quote user="Jill Butterworth"]

Market forces ought respond to respond to the shortage by driving wages up.

[/quote]

Inevitably that money will have to come from somewhere.

RE: The future of independent practice

Clive Ansell — Mon, 06 Aug 2018 16:13:42 GMT

[quote user="Camilla Edwards"]

I'm left wondering - is the partnership model dead?

Will I ever be able to own my own practice, have autonomy over the patient population I care for?

[/quote]

Don't know, but I am noticing across a few different practices in different parts of the country that a small, but increasing, number of clients are asking if the practice is corporate owned, and expressing a desire to attend a locally and independent one instead of a corporate. I have also seen new clients moving away from other practices that have been taken over. There seems to be a niche for it.

I know I'm just a locum, but I would echo others and say go for it.

RE: The future of independent practice

Anthony Todd — Mon, 06 Aug 2018 14:34:56 GMT

[quote user="Bob Russell"]I would hope to work with someone with the view to gradually bowing out.[/quote]

The ideal way to bow out, or not, depending on all sorts of factors!

RE: The future of independent practice

Bob Russell — Mon, 06 Aug 2018 13:58:44 GMT

Martin is a little older than I am and a bit closer to retirement through choice.

I would hope to work with someone with the view to gradually bowing out.

The options are out there and almost ideal for someone wanting to get into a practice but not wanting to be absolutely on their own.

I doubt we are the only two practices looking long term. It would be a great shame for the smallest of practices to whither away by retirement. I have no doubts that there is a lot of growth potential for these independent practices. I for one would love to assist someone with ambition to expand. The corporates are making me busier than ever so the possibilities are there.

Perhaps contact similar types of practices in the area you want to work. It might be the answer to your desire to own your practice. It may be the answer to the present owner/s as well.

Much better than being employed or passing a key percentage of your hard earned cash to a corporate 'partner' in my opinion!

RE: The future of independent practice

Martin Atkinson — Mon, 06 Aug 2018 13:13:18 GMT

[quote user="Camilla Edwards"]Will I ever be able to own my own practice, have autonomy over the patient population I care for?[/quote]Well mine will be up for offer soon. I don't turn over enough to tempt the corporates and the value of the property is too high for someone without capital to afford to buy it but its a nice sole charge SA practice on the outskirts of West London. I'm prepared to to do a deal with no goodwill purchase and even do locums for a song so long as I can treat my own pets for free.

Said with seriousness.

RE: The future of independent practice

Bob Russell — Mon, 06 Aug 2018 11:30:33 GMT

We are budgeting for what I consider to be quite a good deal for a second vet once we have changed banks!

Wages would go up if the market settled rather than one corporate trying to outgrow another and undervaluing what we do as a profession.!

RE: The future of independent practice

Jill Butterworth — Sat, 04 Aug 2018 12:43:21 GMT

Market forces ought respond to respond to the shortage by driving wages up. We might even find all those vets who feel undervalued would come back out of the woodwork and into the job market...

RE: The future of independent practice

Rob Loxley — Sat, 04 Aug 2018 12:36:29 GMT

As CVS' share price took another dive

[quote user="Bob Russell"]Massive amounts of borrowing that is reliant on low interest rates and cooperative lenders[/quote]

Indeed, I wonder how long their lending is fixed for as rates take another little rise

[quote user="Bob Russell"]IVC own little in tangible assets beyond goodwill and staff that I can see

If this is not a bubble then it sure as heck looks like one[/quote]

I see your point

RE: The future of independent practice

Bob Russell — Sat, 04 Aug 2018 10:35:58 GMT

How much does CVS actually own?

Little in bricks and mortar (premises leased), goodwill (that can leach away with the wrong staff in place), posh washing machines and kit that depreciates almost as fast as a new car!

Massive amounts of borrowing that is reliant on low interest rates and cooperative lenders.

Pets at Home lumbered with large warehouse type pet shops in a world where people prefer to get on-line especially from businesses that shirk their tax responsibilities. Toys R Us etc have not coped with this change!

IVC own little in tangible assets beyond goodwill and staff that I can see.

If this is not a bubble then it sure as heck looks like one!

RE: The future of independent practice

grumpyoldman — Sat, 04 Aug 2018 09:39:08 GMT

I thought there had been a slowing down in the market as it peaked but not according to the recent information from Hargreaves and Lansdown on CVS acquisitions:-

ANIMED DIRECT DRIVES GROWTH AT CVS

(Sharecast News) - Integrated veterinary services provider CVS updated the market on its trading for the financial year ended 30 June on Thursday, reporting a 20.7% improvement in total group revenue to £327m.
The AIM-traded firm said like-for-like growth was 4.9%.

As it expected, strong growth in sales of 'Animed Direct' had continued, with the board saying that excluding Animed Direct, like-for-like sales for the group grew 2.9%.

The "unusually severe" snow at the end of February and the start of March was estimated to have reduced sales by around £1.0m, it also claimed.

Adjusted EBITDA for the financial year was anticipated to be "broadly in line" with analysts' consensus expectations, which the directors said reflected the impact of snow, and the lower-than-anticipated short-term performance of some acquisitions.

"Following management action, these acquisitions have shown improvement more recently and they are expected to achieve normal performance levels during the current financial year and beyond," the CVS board said in its statement.

"The board is satisfied with ongoing like-for-like growth since the year end, being at similar levels to the past year."

CVS said the high pace of acquisitions continued in the year to 30 June, with a total of 52 surgeries being acquired.

Approximately £50.6m, including net debt acquired, was paid for those acquisitions.

"Since the interim results issued on 16 February and up to the year-end, 22 surgeries have been acquired for total consideration of £16.9m, including net debt acquired."

CVS Group said it expected to announce its full-year results on 27 September.

After taking the spin away does not sound too clever really, growth 4.9%, year on year ours is 25%+ and I cant remember the last time it dipped below 10%. Also the new acquisitions still performing badly as clients exodus to traditional outlets, as long as there are some left. Probably buying mostly 1-2 vet units and hubbing and spoking them, not making allowances for personal goodwill and hiking fees post acquisition, trying to install healthcare programmes on the unwilling. Replacing the incumbents with cheaper more pliable personnel and down skilling the surgical capabilities.

RE: The future of independent practice

John Wessels — Fri, 03 Aug 2018 22:55:53 GMT

Arlo said:

''Not quite sure what you mean by that. I mean, you have to communicate your services and the benefits to your clients at some point outside the consulting room, whether it be brochures, advertising, PR, websites etc. Are you dismissing all that as fluff??!''

It is in the local parks where all the ''brochures, advertising, PR, websites'' is done.

RE: The future of independent practice

Iain Richards — Fri, 03 Aug 2018 20:52:48 GMT

I assume it's worse case (ie no deal and all non UK vets being evicted).

One of the problems with this is that DEFRA are looking to undermine the definition of a veterinary certificate to make up for the shortfall. Sadly I feel some in RCVS will happily see this if it means they get a new VSA.

RE: The future of independent practice

Silvia Maldonado — Fri, 03 Aug 2018 13:59:38 GMT

So that would be in worse case scenario, wouldn't it?

RE: The future of independent practice

Iain Richards — Fri, 03 Aug 2018 11:51:28 GMT

THE 325% increase in vet need is the previous CVO's estimate of the amount of vet certificates that will be needed if we leave EU with no deal.

RE: The future of independent practice

Cool — Wed, 01 Aug 2018 16:57:39 GMT

I had the same experience Camilla. I think sometimes practice owners assume that other vets are not interested or maybe it is the lure of the better amount they get paid. I would not blame them if they want more money for their practice

RE: The future of independent practice

Gillian Mostyn — Wed, 01 Aug 2018 16:21:41 GMT

As is my experience with CVS. I have been given information about clinical best practice, but never told what to do. (And things like binning injectables after 28 days, using single dose eye lube pipettes for all sedation/GAs etc etc are as much as we are 'told' to do....hardly something you can argue about!)

RE: The future of independent practice

Phil Elkins — Wed, 01 Aug 2018 15:59:35 GMT

Please don't confuse external ownership with clinical freedom. We (Westpoint) have never removed the clinical freedom of any of our vets. We hope to educate on best practice but the treatment choice is up to the vet.

RE: The future of independent practice

Bob Russell — Wed, 01 Aug 2018 13:04:17 GMT

95% of vets are from the EU because the Meat Hygiene Service put contracts out to tender and the cheapest won.

This was at the expense of OVS's sometimes with decades of experience! Some were, admittedly, pretty awful but we knew who they were as did the service.

Serves them right for going for cheap rather than factor in this experience which has been lost for good.

RE: The future of independent practice

Camilla Edwards — Wed, 01 Aug 2018 11:45:12 GMT

Silvia Maldonado I think it comes from this report from the BVA. 95% of vets in the meat industry are from the EU and that is where a massive shortfall will occur. https://www.bva.co.uk/uploadedFiles/Content/News,_campaigns_and_policies/Policies/Future_of_the_profession/brexit-and-veterinary-profession-v.1.0.pdf

RE: The future of independent practice

Bob Russell — Wed, 01 Aug 2018 11:43:54 GMT

I disagree with the idea that most people are happy to see anyone for routine stuff. Most will tolerate it but not be that happy.

How often do you hear 'you always see someone different'?

Routine appointments are the chance to get to know the owner/patient and the owner/patient to get to know you! Not essential but definitely desirable.

Most people come to us based on word of mouth therefore the premises are less important than you may think.

Nice new premises (just like new cars) tends to bring out the 'you must be charging too much if you can afford this'!

RE: The future of independent practice

Silvia Maldonado — Wed, 01 Aug 2018 11:21:59 GMT

From where the figures of "a predicted 300% shortfall in veterinary surgeons when we leave the EU" are coming, I don't know.

I want to share this piece of news I've been sent today to discuss and see what you think about it. If shortage of staff is already hitting independent practices, what does the future hold?

https://www.vetnurse.co.uk/b/veterinary-nursing-news/archive/2018/07/31/veterinary-surgeon-silences-nigel-farage.aspx?utm_source=dlvr.it&utm_medium=facebook

RE: The future of independent practice

Arlo Guthrie — Wed, 01 Aug 2018 11:01:35 GMT

[quote user="Edward Jones"]The truth is somewhere in between, but what happens in the consulting room trumps PR[/quote]

It shouldn't be about one thing trumping the other. Consulting room skills work in concert with advertising, digital communications, PR, and all the other marketing communications disciplines, which target clients at different times.

[quote user="Edward Jones"]I prefer those who don't rate the PR-fluff[/quote]

Not quite sure what you mean by that. I mean, you have to communicate your services and the benefits to your clients at some point outside the consulting room, whether it be brochures, advertising, PR, websites etc. Are you dismissing all that as fluff??!

For me, it's only fluff when the quality of the service doesn't match the description in the brochure.

RE: The future of independent practice

Edward Jones — Wed, 01 Aug 2018 10:33:50 GMT

[quote user="Arlo Guthrie"]

[quote user="George Cooper"]Point three. Branding is bollox, meaningless, as is all the effort on facebook, website provision, presentation - because what matters is the vet IN THE CONSULT ROOM. "My Vet!"[/quote]

George, you old dinosaur. I couldn't disagree with you more!

[/quote]

The truth is somewhere in between, but what happens in the consulting room trumps PR - although it completely depends on your USP. Personally, I'm picky about my clients, and I prefer those who don't rate the PR-fluff, for example.

RE: The future of independent practice

Arlo Guthrie — Wed, 01 Aug 2018 09:56:50 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Arlo Guthrie"]Sorry, but where is the evidence for this? I have a 5 year old (I think) dog that has so far only rarely needed to be seen by a vet, and honestly, I don't give a monkeys which vet my dog sees for routine stuff! [/quote]

Well, other people do give a monkey's, as would I. The evidence? Just what people tell me, and my own opinion which is of course very very important [/quote]

I suppose I am just making the distinction between routine, mundane stuff like annual checkups, parasite control, etc., where it seems to me far less important that you see the same vet, as opposed to the treatment of specific, longer term illnesses.

[quote user="George Cooper"]In your little list, Arlo, I'd agree with the first part of point one, and disagree with the second part of the first point. [/quote]

aha, George Cooper, so I just swerved a 'disagree' from you then!

Interesting, I'm reading into your post that you think corporates offer such a poor service (lack of continuity / lack of staff with english as a first language etc.) that it's enough to compete on good, old fashioned service. Interesting. I'm not saying I disagree. But what if a) that is a bit of an overgeneralisation of corporates, or b) they up their game?

George, you old dinosaur. I couldn't disagree with you more!

I mean, OF COURSE the vet in the consulting room is the single most important factor in the equation. But what about all those clients who haven't met him or her. Facebook, websites and other forms of marketing are crucial at different stages of the (this will make you wince) 'consumer journey'.

Branding and presentation are also very important. You put your first class, uber-charming, uber-qualified, uber-skilled veterinary surgeon in a shithole, and I'll bet you all the money in the world that, all other things being equal, they won't pull in as many clients as the vet working in a nice environment. But take that a step further. The visitor to a corporate business (veterinary practice, optician, burger outlet, whatever) is often presented with a nice 'safe', slightly bland experience. Unremarkable. Unmemorable. Independents can stand out better against this kind of competition. Be remarkable. Be memorable.

(caveat, I know that some groups allow their practices to retain their individual identity, a good thing IMO, at which point this argument falls down).

RE: The future of independent practice

George Cooper — Tue, 31 Jul 2018 19:01:12 GMT

[quote user="Niall Taylor"]

[quote user="George Cooper"]...on the day that a buyer had been found and was due to actually sign the deal, it backfired spectacularly.[/quote]

Just out of curiosity and please feel free to not answer but did it backfire because you discussed things with the staff, or were there other reasons?

Niall

[/quote]

Happy to outline the entire sorry saga!

Largely I believe that it was because everyone was aware that I was selling, though it was more involved than that. Had the LA part of the team been unaware and the sale had gone through I believe the ultimate outcome would have been totally different.

As it happened, because there was a bit of fundraising going on following the death of my wife, John Bonner wrote a pretty accutrate article in Vet Practice Magazine which at that time was owned by David Ritchie and published in PDF format on vet surgeon.org - cant locate it at the mo, tho.