Differences in perceptions and satisfaction exist among veterinarians employed at corporate versus privately owned veterinary clinics

Lori R. Kogan College of VeterinaryMedicine and Biomedical Sciences, Colorado State University, Fort Collins, CO

Search for other papers by Lori R. Kogan in
Current site
Google Scholar
PubMed
Close
 PhD
and
Mark Rishniw Veterinary Information Network, Davis, CA

Search for other papers by Mark Rishniw in
Current site
Google Scholar
PubMed
Close
 PhD

Abstract

OBJECTIVE

To compare and contrast the views of benefits and general work conditions of participants working in corporate hospitals compared to those working in privately owned hospitals.

SAMPLE

Veterinary members of the Veterinary Information Network (VIN) working as associate veterinarians in corporate- or privately owned hospitals.

METHODS

An electronic survey distributed via the VIN data collection portal.

RESULTS

A total of 896 responses from associate veterinarians working full time were received, of which 286 (31.9%) reported working in private practice and 610 (68.1%) in corporate practice. Fifty-five percent of participants indicated a preference for working in private practice compared to 12% preferring corporate practice. Veterinarians working in corporate practice were more likely to report receiving insurance (health, dental, life, and short-term disability), mental wellness programs (eg, counseling), wellness mobile apps, VIN membership, and continuing education paid by their employer than those working in privately owned practices. However, participants in private practice reported higher satisfaction with feeling known as an individual by upper management, hospital culture, the ability to fire difficult or abusive clients, and mentorship. Those working in corporate practices reported feeling more pressure than those in private practice to generate revenue and see more clients per shift.

CLINICAL RELEVANCE

There are positives and negatives of corporate-owned hospitals when compared to privately owned practices. Corporate hospitals may be well positioned to make large organizational-level changes that can improve work culture and, as a result, the well-being and retention of small animal practitioners.

Abstract

OBJECTIVE

To compare and contrast the views of benefits and general work conditions of participants working in corporate hospitals compared to those working in privately owned hospitals.

SAMPLE

Veterinary members of the Veterinary Information Network (VIN) working as associate veterinarians in corporate- or privately owned hospitals.

METHODS

An electronic survey distributed via the VIN data collection portal.

RESULTS

A total of 896 responses from associate veterinarians working full time were received, of which 286 (31.9%) reported working in private practice and 610 (68.1%) in corporate practice. Fifty-five percent of participants indicated a preference for working in private practice compared to 12% preferring corporate practice. Veterinarians working in corporate practice were more likely to report receiving insurance (health, dental, life, and short-term disability), mental wellness programs (eg, counseling), wellness mobile apps, VIN membership, and continuing education paid by their employer than those working in privately owned practices. However, participants in private practice reported higher satisfaction with feeling known as an individual by upper management, hospital culture, the ability to fire difficult or abusive clients, and mentorship. Those working in corporate practices reported feeling more pressure than those in private practice to generate revenue and see more clients per shift.

CLINICAL RELEVANCE

There are positives and negatives of corporate-owned hospitals when compared to privately owned practices. Corporate hospitals may be well positioned to make large organizational-level changes that can improve work culture and, as a result, the well-being and retention of small animal practitioners.

Introduction

Traditionally, veterinary practices have been privately owned and operated by an individual veterinarian or a small group of veterinarians.1 However, in recent years, a number of large corporations have purchased and consolidated numerous independently owned veterinary practices, thereby changing the face of veterinary medicine.2 Corporate involvement in veterinary medicine began in 1987 when Veterinary Centers of America Inc (VCA) purchased its first independently owned veterinary clinic. Shortly after, Banfield/Medical Management International Inc entered a partnership with PetSmart and began opening veterinary clinics in PetSmart stores. Mars Inc followed, entering the veterinary field in 1994 when it bought Banfield Pet Hospital, then BluePearl in 2015 and VCA Inc in 2018.3

Acquisition and consolidation of veterinary practices appeals to large corporations because it offers a safe, lucrative investment for corporations looking to diversify and make a profit. There are now over 60 veterinary consolidators,4 and most CEOs of these consolidators are not veterinarians.5 Approximately 75% of specialty and emergency clinics and 25% of all first-opinion clinics in the US are owned by corporate consolidators,5,6 and estimates suggest that consolidators control around 50% of all US veterinary hospital revenue.6

There are approximately 126,000 practicing veterinarians in the US; 75,000 work in private practice.7 These veterinarians are increasingly faced with the decision of whether to work in a corporate-owned or a privately owned practice. One frequently touted positive aspect of working for a corporate-owned practice is the benefits package, including health insurance, paid vacation time, continuing education reimbursement, retirement, and paid sick leave.8,9 It has been suggested that consolidation can save money, thereby enabling corporations to offer more and better benefits. Yet the ability of corporations to increase employee benefits has not always translated into a reality, with some veterinary professionals reporting worse benefits after their practice transitioned to corporate ownership.10

Corporate hospitals have also been perceived as a good option for veterinarians who want predictable hours and manageable workloads, better mentoring, and the ability to move to other hospitals within the corporate umbrella.1,8 It has also been suggested that corporate hospitals offer career opportunities and professional growth not always available within privately owned hospitals.4 Other noted advantages of corporate ownership include the ability to upgrade aging hospitals, often with state-of-the-art equipment4; have business and administration tasks managed by people trained in these tasks11; and be able to buy in bulk and therefore pass savings on to pet owners.1,12

On the other hand, much has been written about the potential negative aspects of corporate hospitals. These factors include the risk that consolidated hospitals may not be as responsive to employees’ opinions when compared to privately owned hospitals,8 decreased ability of employees to have a role in practice management and animal healthcare policies, and difficulty in communicating concerns or ideas to upper management.1,12 The culture may be less “family friendly” and offer less flexibility pertaining to working conditions.11 Additionally, there may be prolonged approval processes for new equipment or changes in protocol. Another common criticism of corporate hospitals is an overriding focus on making a profit, creating an atmosphere of pressure to increase profit margins.1

Despite these purported benefits and detriments, we know of no studies to ascertain the views of veterinarians working in corporate hospitals compared to those working in privately owned hospitals. Given the growing number of corporate hospitals, we felt it important to assess differences in how veterinarians view their workplace to help clinicians make educated decisions about employment options. Therefore, we compared and contrasted the views of participants working in corporate hospitals to those working in privately owned hospitals about benefits and general work conditions. Our overarching research question was whether there are differences in the views of veterinarians working in corporate versus private practices pertaining to their workplace and, if so, where these differences lie. The study design and survey items were based on 2 organizational behavior theories. The human relations management theory suggests that employee productivity, motivation, and satisfaction can be increased through positive social connections in the workplace and acknowledgment of the employee as a unique individual,13,14 while job demands–resource theory postulates that burnout and work engagement may be the result of excessive job demands coupled with inadequate resources.15,16

Methods

We created an online survey and distributed a link to the survey via email to veterinarian members of the Veterinary Information Network (VIN), an online community for veterinarians (n = approx 43,000). Participants could anonymously access the survey from January 12, 2022, through February 6, 2022. A follow-up message was sent 2 weeks after the initial invitation. We included data only from respondents who stated they currently worked in clinical practice either in a brick-and-mortar private practice (ie, not mobile, shelter, academia, or relief/locum) or a corporate practice and were not currently in an internship or residency program. We defined private practice as “brick-and-mortar private practice (ie, not mobile, not shelter, not academia, not relief/locum, not owned by a corporation)” and corporate practice as “corporate practice (eg, Banfield, VCA, Blue Pearl, etc).” Because we wanted to assess the perceptions of practitioners working in private or corporate practice, the decision was made to exclude respondents who work as academic, shelter, mobile, or relief veterinarians. Furthermore, because several of the survey questions pertained to benefits, we limited our sample to associate veterinarians who categorized their work as full time. The study was categorized as exempt by Colorado State University’s Institutional Review Board. The survey was administered directly via the VIN data collection portal, and branching logic was used to display only relevant questions to each participant. The body of the survey consisted of demographic questions including full- or part-time status, eligibility for benefits, type of practice (eg, first opinion or emergency medicine, specialty [referral] medicine, or other), current role (associate or owner/partner—for private practice only), currently in a leadership position, and future interest in leadership positions or becoming an owner or partner. Personal demographics included gender and veterinary school graduation year.

Participants were asked to indicate, from a list of possible options, all the benefits they currently receive and their satisfaction level (using a 5-point Likert scale, with 1 = very unsatisfied and 5 = very satisfied)17 with the benefits they receive. They were also asked to indicate their satisfaction (using a 5-point Likert scale with 1 = very unsatisfied and 5 = very satisfied) with several items pertaining to their hospital (eg, standard of medicine, hospital flow, and administration) and personal aspects (eg, feel your voice is heard, ability to change health-related protocols, and work schedule) of their work. They were then asked to report (using a 5-point Likert scale from none to extreme) how much pressure they feel from management regarding generating revenue, seeing more clients per shift, working longer hours, not referring cases, and following specific protocols for disease diagnosis and treatment.

Lastly, participants were asked to indicate their preference (or no preference) for private noncorporate versus corporate practice. A final question at the end of the survey allowed for free-text entry for any comments participants chose to make about why they preferred private or corporate practice. Because the survey focused on benefits received and satisfaction level, only associate veterinarians (not owners or partners) who reported working full time were included in the analysis (Supplementary Material S1).

Descriptive statistics and χ2 tests were performed with SPSS Statistics (version 28; IBM Corp). Because of the categorical nature of the data, χ2 tests18 were used to test for differences between private practice and corporate practice for the questions pertaining to benefits (available and satisfaction level) and satisfaction level with items pertaining to their hospital and personal aspects of their work. To determine whether personal demographics could predict current type of employment (private or corporate practice), logistical regression was used to predict current type of employment on the basis of participants’ gender and year of veterinary school graduation. The χ2 test18 was also used to assess the relationship between participants’ preference for private noncorporate or corporate practice and whether they currently work in private noncorporate or corporate practice. Due to the number of analyses, significance level was set at 0.005.

Results

Demographics

We received 896 responses from associate veterinarians working full time, of which 286 (31.9%) reported working in private practice and 610 (68.1%) in corporate practice. Fifty percent (449/896) reported working in a hospital with 3 or fewer full-time veterinarians, 42% (361/896) reported working with 4 to 9 full-time veterinarians, and 8% (86/896) reported working with 10 or more full-time veterinarians. Nearly all (856/896 [95.5%]) reported working in a first-opinion or emergency medicine practice. The respondents were predominately female (675/896 [75.4%]), with 195 (21.8%) reporting that they graduated in 1993 or earlier, 241 (26.9%) between 1994 and 2003, 244 (27.2%) between 2004 and 2013, and 216 (24.1%) between 2014 and 2023.

When asked about leadership roles, 369 of 896 (41.2%) indicated currently being in a leadership position. Of those not in a leadership position (n = 527), 236 (44.8%) reported not being interested in ever obtaining a nonowner leadership role, 145 (27.5%) reported being interested, and 146 (27.7%) reported being unsure. All participants were asked if they were interested in ever becoming an owner or partner, to which 472 (52.7%) reported no, 250 (27.9%) reported yes, and 173 (19.3%) were unsure.

Benefits

Participants were asked to indicate which benefits, from a list of 20, that they receive. The benefits reported to be received most often included a variety of insurances (ie, health, dental, malpractice, short-term disability, long-term disability, and life). A greater proportion of participants working in corporate practices reported receiving 8 of the benefits than participants working in private practice. These benefits included the following: health insurance, dental insurance, short-term disability, long-term disability, life insurance, mental wellness programs, wellness mobile apps, and VIN membership (Table 1). We found no differences in satisfaction level for any of the received benefits between those working in corporate practices compared to private practice. We found no differences in the total number of benefits with which participants were very satisfied (P = .31), satisfied (P = .89), unsatisfied (P = .18), or very unsatisfied (P = .37). Respondents in corporate practice rated their satisfaction level with their benefits as neutral more frequently than those in private practice (P < .001).

Table 1

Participants in private practice and corporate practice and their reported received benefits.

Private n (%) Corporate n (%) χ2
Health insurance 100 (35.0%) 286 (74%) χ2 = 11.28 (1), P < .001
Dental insurance 70 (24.5%) 244 (46.9%) χ2 = 20.62 (1), P < .001
Malpractice insurance 92 (32.2%) 254 (40.0%) χ2 = 7.37 (1), P = .007
Short-term disability insurance 27 (9.4%) 157 (41.6%) χ2 = 31.69 (1), P < .001
Long-term disability insurance 19 (6.6%) 124 (25.7%) χ2 = 27.19 (1), P < .001
Life insurance 28 (9.8%) 152 (20.3%) χ2 = 27.76 (1), P < .001
Maternity/paternity leave 35 (12.2%) 119 (24.9%) χ2 = 7.23 (1), P = .007
Paid time off 105 (36.7%) 276 (19.5%) χ2 = 5.80 (1), P = .016
Retirement 73 (25.5%) 216 (45.2%) χ2 = 8.71 (1), P = .003
Mental wellness programs (eg, counseling) 23 (8.0%) 193 (35.4%) χ2 = 59.26 (1), P < .001
Physical wellness programs (eg, gym membership) 7 (2.4%) 42 (31.6%) χ2 = 7.42 (1), P = .006
Wellness apps 5 (1.7%) 95 (6.9%) χ2 = 37.54 (1), P < .001
Bonus or time off for an exceptionally difficult work period 13 (4.5%) 14 (15.6%) χ2 = 3.37 (1), P = .066
Veterinary licensing fees 113 (39.5%) 290 (2.3%) χ2 = 5.07 (1), P = .024
Veterinary association fees 105 (36.7%) 250 (47.5%) χ2 = 1.48 (1), P = .223
VIN membership fees 82 (28.7%) 245 (41.0%) χ2 = 11.10 (1), P < .001
Other professional fees (eg, DEA license fees, journal subscriptions) 89 (31.1%) 252 (40.2%) χ2 = 8.58 (1), P = .003
Tuition or education loan assistance 1 (0.3%) 17 (41.3%) χ2 = 5.88 (1), P = .015
CE or CPD paid for by employer 101 (35.3%) 289 (2.8%) χ2 = 11.53 (1), P < .001
Time off for CE or CPD 86 (30.1%) 257 (47.4%) χ2 = 11.99 (1), P < .001
Discounted or free pet exam 114 (39.9%) 288 (42.1%) χ2 = 4.26 (1), P = .039
Discounted or free bloodwork for pets 122 (42.7%) 297 (47.2%) χ2 = 2.85 (1), P = .092
Discounted or at-cost surgery for pets 118 (41.3%) 287 (48.7%) χ2 = 2.64 (1), P = .104
Discounted or at-cost drugs for pets 121 (42.3%) 292 (47.0%) χ2 = 2.42 (1), P = .120
Discounted or at-cost pet food 93 (32.5%) 246 (47.9%) χ2 = 5.05 (1), P = .025
Discounted or at-cost pet supplies 85 (29.7%) 206 (40.3%) χ2 = 1.46 (1), P = .227
Discounted pet boarding 48 (16.8%) 115 (33.8%)

Bolded values indicate significance.

CE = Continuing education. CPD = Continuing professional development. DEA = Drug Enforcement Administration. VIN = Veterinary Information Network.

Hospital factors

Participants working in private practice reported higher levels of satisfaction than those working in corporate practice for the following several hospital factors: administration (P < .001), ability to get new/different drugs (P < .001), ability to acquire new large equipment (eg, digital radiography, ultrasound, or other imaging; P = .002), time needed to make changes in health-related (P = .005) or workflow protocols (P < .001), management’s acknowledgment of the value of community outreach by staff (P < .001), and relationship between management and employees (P < .001; Table 2).

Table 2

Reported satisfaction level of participants in private practice and corporate practice with hospital factors.

Private Corporate
Very dissatisfied n (%) Dissatisfied n (%) Neutral n (%) Satisfied n (%) Very satisfied n (%) Very dissatisfied n (%) Dissatisfied n (%) Neutral n (%) Satisfied n (%) Very satisfied n (%)
Standard of medicine 2 (< 1%) 9 (3%) 14 (5%) 79 (28%) 181 (64%) 13 (2%) 21 (4%) 24 (4%) 167 (28%) 382 (63%)
Case turnover and ability to get treatments or diagnostics done 2 (< 1%) 11 (4%) 19 (7%) 111 (39%) 142 (50%) 8 (1%) 38 (6%) 56 (9%) 239 (39%) 266 (44%)
Administration 6 (2%) 53 (19%) 45 (16%) 118 (41%) 63 (22%) 65 (11%) 129 (21%) 109 (18%) 198 (33%) 107 (18%)
Hospital flow: speed of getting treatments or diagnostics done 2 (< 1%) 28 (10%) 39 (14%) 125 (44%) 90 (32%) 12 (2%) 93 (15%) 86 (14%) 242 (40%) 176 (29%)
Physical space to examine and treat animals 7 (3%) 47 (17%) 27 (10%) 107 (38%) 96 (34%) 24 (4%) 109 (18%) 68 (11%) 184 (30%) 224 (37%)
Practice management software/medical record system 9 (3%) 52 (18%) 54 (19%) 106 (37%) 63 (22%) 37 (6%) 90 (15%) 120 (20%) 224 (37%) 136 (22%)
Time needed to make changes in hospital workflow protocols 5 (2%) 55 (20%) 81 (29%) 83 (30%) 54 (19%) 50 (8%) 161 (27%) 150 (25%) 170 (28%) 71 (12%)
Time needed to make changes in health-related protocols 2 (< 1%) 33 (12%) 68 (25%) 104 (37%) 71 (26%) 26 (5%) 86 (15%) 145 (25%) 212 (37%) 104 (18%)
Ability to get new/different drugs 2 (< 1%) 16 (6%) 26 (9%) 103 (36%) 138 (48%) 19 (3%) 43 (7%) 76 (13%) 257 (42%) 211 (35%)
Ability to acquire new smaller equipment 5 (2%) 18 (6%) 34 (12%) 105 (37%) 124 (43%) 20 (3%) 64 (11%) 67 (11%) 222 (37%) 234 (39%)
Ability to acquire new large equipment 6 (2%) 36 (13%) 70 (25%) 113 (41%) 52 (19%) 44 (7%) 97 (16%) 168 (28%) 209 (35%) 76 (13%)
Role of human resources at your hospital 16 (6%) 50 (20%) 57 (23%) 86 (35%) 40 (16%) 70 (12%) 110 (19%) 147 (25%) 170 (29%) 88 (15%)
Hospital regulations regarding social media outside of work 2 (< 1%) 12 (6%) 60 (28%) 85 (39%) 57 (26%) 11 (2%) 26 (5%) 187 (38%) 157 (32%) 106 (22%)

Similarly, participants working in private practice reported higher levels of satisfaction than those working in corporate practice for issues pertaining to wages for technicians/nurses (P < .001), reception and other support staff (P < .001), and production-based remuneration for veterinarians (P = .002). Differences were also found in satisfaction about turnover rates of veterinarians (P < .001), technicians/nurses (P < .001), and other support staff (P < .001; Table 3).

Table 3

Reported satisfaction level of participants in private practice and corporate practice with wages and turnover rates.

Private Corporate
Very dissatisfied n (%) Dissatisfied n (%) Neutral n (%) Satisfied n (%) Very satisfied n (%) Very dissatisfied n (%) Dissatisfied n (%) Neutral n (%) Satisfied n (%) Very satisfied n (%)
Wages for technicians/nurses 2 (< 1%) 68 (30%) 51 (23%) 77 (34%) 26 (12%) 73 (13%) 176 (32%) 110 (20%) 133 (25%) 51 (9%)
Wages for reception and other support staff (excluding technicians) 3 (1%) 60 (28%) 56 (26%) 69 (32%) 25 (12%) 63 (12%) 159 (31%) 126 (24%) 126 (24%) 48 (9%)
Base salary 5 (2%) 25 (9%) 33 (12%) 136 (48%) 84 (30%) 19 (3%) 85 (14%) 73 (12%) 244 (41%) 169 (29%)
Production-based 2 (1%) 17 (10%) 17 (10%) 75 (43%) 64 (37%) 31 (6%) 76 (15%) 82 (16%) 178 (35%) 149 (29%)
Turnover rate of veterinarians 2 (< 1%) 23 (9%) 42 (16%) 76 (28%) 125 (47%) 42 (7%) 94 (16%) 112 (19%) 171 (29%) 166 (28%)
Turnover rate of technicians/nurses 12 (4%) 48 (17%) 53 (19%) 95 (34%) 69 (25%) 92 (15%) 146 (25%) 108 (18%) 164 (28%) 86 (14%)
Turnover rate of other support staff 16 (6%) 57 (21%) 60 (22%) 92 (34%) 50 (18%) 88 (15%) 157 (27%) 135 (23%) 149 (25%) 63 (11%)

Participants working in private practice reported higher levels of satisfaction than those working in corporate practice for the following several factors pertaining to participants’ experiences with their hospitals: feeling known as an individual by upper management (P < .001), feeling their voice is heard (P < .001), the ability to fire difficult or abusive clients (P = .003), the hospital culture (P < .001), and mentorship (P = .003; Table 4).

Table 4

Reported satisfaction level of participants in private practice and corporate practice with participants’ experiences with their hospitals.

Private or corporate Private Corporate
Very dissatisfied n (%) Dissatisfied n (%) Neutral n (%) Satisfied n (%) Very satisfied n (%) Very dissatisfied n (%) Dissatisfied n (%) Neutral n (%) Satisfied n (%) Very satisfied n (%)
Ability to change workflow protocols 8 (3%) 50 (18%) 66 (23%) 107 (38%) 53 (19%) 39 (7%) 114 (19%) 131 (22%) 180 (30%) 136 (23%)
Ability to change health-related protocols 0 (0%) 21 (8%) 70 (25%) 125 (45%) 62 (22%) 13 (2%) 56 (10%) 155 (27%) 202 (35%) 153 (26%)
Ability to practice the way you think most appropriate for each case 0 (0%) 7 (3%) 15 (5%) 66 (23%) 194 (69%) 11 (2%) 17 (3%) 26 (4%) 193 (32%) 358 (59%)
Ability to fire difficult or abusive clients 9 (3%) 43 (15%) 37 (13%) 87 (31%) 103 (37%) 53 (9%) 75 (13%) 106 (18%) 191 (32%) 172 (29%)
Culture of hospital 3 (1%) 29 (10%) 31 (11%) 116 (41%) 105 (37%) 30 (5%) 95 (16%) 97 (16%) 217 (36%) 170 (28%)
Collegiality between doctors 3 (1%) 11 (4%) 15 (5%) 94 (34%) 155 (56%) 9 (2%) 24 (4%) 45 (8%) 213 (36%) 308 (51%)
Collegiality between doctors and support staff 1 (< 1%) 8 (3%) 23 (8%) 116 (41%) 137 (48%) 10 (2%) 29 (5%) 52 (9%) 258 (42%) 259 (43%)
Management support for dealing with difficult clients 6 (2%) 32 (11%) 48 (17%) 94 (33%) 106 (37%) 27 (5%) 72 (12%) 93 (16%) 233 (39%) 175 (29%)
Peer support 4 (1%) 19 (7%) 27 (10%) 103 (37%) 124 (45%) 19 (3%) 30 (5%) 93 (15%) 248 (41%) 213 (35%)
Mentorship 8 (4%) 17 (7%) 37 (16%) 96 (42%) 72 (31%) 27 (5%) 70 (14%) 117 (23%) 165 (33%) 129 (25%)
Leadership 11 (4%) 51 (18%) 59 (21%) 106 (37%) 59 (21%) 58 (10%) 106 (18%) 132 (22%) 213 (35%) 93 (15%)
Management’s acknowledgment of the value of community outreach by staff 6 (3%) 40 (18%) 75 (34%) 65 (29%) 37 (17%) 56 (11%) 97 (19%) 173 (35%) 108 (22%) 67 (13%)
Relationship between management and employees 7 (3%) 39 (14%) 66 (23%) 102 (36%) 71 (25%) 59 (10%) 133 (22%) 127 (21%) 181 (30%) 102 (17%)
Work schedule: hours per week 3 (1%) 28 (10%) 30 (11%) 121 (42%) 104 (36%) 13 (2%) 59 (10%) 74 (12%) 275 (45%) 189 (31%)
Work schedule: length of shifts 5 (2%) 29 (10%) 35 (12%) 117 (41%) 98 (35%) 10 (2%) 62 (10%) 93 (15%) 287 (47%) 157 (26%)
Work schedule: flexibility to personalize 5 (2%) 34 (12%) 43 (16%) 91 (33%) 105 (38%) 16 (3%) 80 (13%) 94 (16%) 238 (40%) 175 (29%)
Personal case load 5 (2%) 27 (10%) 42 (15%) 138 (48%) 73 (26%) 20 (3%) 78 (13%) 103 (17%) 255 (42%) 153 (25%)
Able to leave work at scheduled/contracted time 21 (7%) 56 (20%) 44 (15%) 90 (32%) 74 (26%) 67 (11%) 117 (19%) 105 (17%) 177 (29%) 143 (24%)
Feel like you are known as an individual by upper management 3 (1%) 9 (3%) 9 (3%) 54 (19%) 210 (74%) 76 (13%) 104 (17%) 118 (20%) 129 (21%) 178 (29%)
Feel your voice is heard 6 (2%) 24 (8%) 35 (12%) 89 (31%) 131 (46%) 77 (13%) 136 (22%) 118 (19%) 157 (26%) 121 (20%)

When participants were asked to indicate how much pressure they feel from management related to revenue, work hours, and following specific protocols, those in corporate practices reported feeling more pressure than those in private practice to generate revenue (P < .001) and see more clients per shift (P < .001; Table 5).

Table 5

Reported pressures felt by participants in private practice and corporate practice.

Private Corporate
None A little Moderate Considerable Extreme None A little Moderate Considerable Extreme
Generate practice revenue 78 (28%) 93 (33%) 74 (26%) 30 (11%) 6 (2%) 65 (11%) 149 (25%) 172 (29%) 153 (25%) 64 (11%)
See more clients per shift 117 (41%) 70 (25%) 53 (19%) 37 (13%) 6 (2%) 162 (27%) 136 (23%) 141 (23%) 104 (17%) 61 (10%)
Work longer shifts or work beyond contracted shift 166 (59%) 49 (17%) 42 (15%) 20 (7%) 4 (1%) 327 (54%) 111 (18%) 80 (13%) 54 (9%) 34 (6%)
Not refer cases 213 (77%) 38 (14%) 21 (8%) 4 (1%) 1 (< 1%) 449 (77%) 70 (12%) 43 (7%) 13 (2%) 8 (1%)
Follow specific protocols for disease diagnosis and treatment 198 (70%) 64 (23%) 16 (6%) 4 (1%) 1 (< 1%) 444 (74%) 111 (18%) 31 (5%) 9 (2%) 8 (1%)

Place of employment

Leadership role—Participants in leadership roles were more likely to be working in a corporate practice (282 [76.4%]) than those not in leadership role (328 [62.2%]; P < .001). We observed no difference on future interest in obtaining a leadership position (excluding owner or partner), but a greater proportion of participants working in private practice expressed interest in being an owner or partner in the future (101 [40.4%] vs 120 [25.4%]; P < .001). No differences were found between stated interest in a leadership role (not partner or owner) and preference for corporate practice or private practice (P = .921).

Predictors of working in corporate practice or private practice—When examining what demographic characteristics (gender and year of graduation) might predict a participant’s current place of employment (corporate or private), we found that the more recently a participant graduated, the more likely they were to report working in private practice (P < .0001); participants who graduated between 2014 and 2023 were more likely to work in private practice than those who graduated in 2003 or earlier (Supplementary Table S1).

Preference for corporate practice or private practice—Participants were asked to indicate their preference for working in corporate practice or private practice (or having no preference), if they assumed “all things being equal.” A total of 104 (11.6%) indicated they prefer corporate practice, 494 (55.1%) indicated they prefer private practice, 223 (24.9%) had no preference, and 75 (8.4%) said they don’t know. Regardless of whether participants worked in private practice or corporate practice, most preferred private practice (n = 234, 90% of those working in private practice, and 260, 46% working in corporate practice). We found no differences between participants of different genders (P = .23) or graduation year (P = .44) and associations with preference (corporate, private, or no preference). However, a larger percentage of those working in corporate practice preferred corporate practice than those currently working in private practice (102 [18.1%] vs 2 [0.8%]) or having no preference (200 [35.6%] vs 23 [8.9%]; P < .001; Table 6).

Table 6

Participants’ current workplace and preference for working in private practice or corporate practice.

Current workplace Preference
Corporate Private noncorporate practice No preference
Private 2 (1%) 234 (90%) 23 (9%)
Corporate 102 (18%) 260 (46%) 200 (36%)

Discussion

Our study highlighted differences in perceptions surrounding veterinary employment in corporate and private practices. Although corporate practice employees reported receiving more benefits, a greater proportion of participants indicated a preference for working in private practice (55%) compared to corporate practice (12%), with no differences in preference based on gender or years since graduation. Veterinary employees were equally satisfied with the benefits they received. However, those in private practice expressed greater satisfaction with multiple hospital environment factors. This suggests that the desire of many veterinary employees to work in private practice, if they could, appears unrelated to benefits but more likely a reflection of corporate work culture and environment.

Somewhat surprisingly, we found that recent graduates were more likely to report working in private practice. With the unemployment rate for veterinarians at a record low of 0.5% in 2022,19 recruiting and retaining veterinarians has perhaps never been more important. Yet despite the fact that corporate practices have over 3 times the number of job listings as private practices, the number of veterinarians going into corporate practices does not match the available jobs.19 In fact, since 2019, the percent of veterinarians going into corporate practice has been trending slightly downward,19 meaning that even though the number of job opportunities for veterinarians within corporate practices continues to rise, many veterinarians are making other choices. This may be due in part to the number of younger veterinarians interested in entrepreneurial and intrapreneurial (entrepreneurial behavior within a business not owned by themselves) opportunities.20 In addition, in terms of retention, studies suggest that 33% to 50% of new graduates leave their first employment position within their first 2 years, most commonly due to a lack of support or a toxic work environment.2124 Unfortunately, to our knowledge, a comparison of attrition rates between corporate and private practice has not been conducted; a study of this nature would be helpful in further illuminating potential differences between the 2 types of practices.

Several positive features are often mentioned in relation to corporate practices, one of which pertains to better benefits. Our study supports the premise that corporate practices offer more benefits to their employees than private practices. Participants in our study working in corporate practice were more likely to report receiving insurance (health, dental, life, and short-term disability), mental wellness programs (eg, counseling), wellness mobile apps, VIN membership, and continuing education paid by their employer than those working in privately owned practices. There were, however, no differences between the 2 groups in satisfaction levels for any of the benefits received. Yet, for many veterinarians, the availability of insurance, and especially health insurance, is an important consideration when seeking employment.

In addition to more benefits, it has been suggested that corporate practices offer more predictable hours and manageable workloads.1,8,12 However, we found no differences in satisfaction levels between those working in corporate or private practices for any of the survey items pertaining to schedule (ie, hours per week, length of shifts, ability to leave work at the scheduled time, or flexibility to personalize) or personal case load.

It has also been proposed that corporate practices are able to run more efficiently because business and administration tasks are handled by those trained to complete these tasks11,12 and, because of increased capital, corporate practices can invest in better facilities and equipment.2 Nevertheless, we found no differences in participants’ responses based on working in a corporate versus private hospital in terms of their ability to acquire smaller equipment (and, in fact, those in private practice reported an easier time acquiring large equipment) or in their ability to get treatments or diagnostics done, hospital flow, physical space to examine and treat animals, or practice management software/medical record systems.

Furthermore, despite corporate practices’ additional capital, participants from corporate practices reported feeling less satisfied with wages for technicians/nurses, reception and other support staff, and veterinary production-based remuneration. They also reported less satisfaction with turnover rates among all employees (ie, technicians/nurses, reception and other support staff, and veterinarians).

For veterinarians seeking leadership roles, it has been suggested that corporate practices may offer more opportunities.12 Although we found that participants in leadership roles were more likely to be working in a corporate setting, we found no difference in current work setting based on future interest in obtaining a leadership position. Given the large number of veterinary students interested in leadership roles within veterinary medicine, as well as intrapreneurship opportunities,20,25 it might be helpful for corporate practices to better communicate to potential and employed associate veterinarians about leadership opportunities and pathways to achieving expanded roles.

When we assessed differences in satisfaction levels for several work-related factors reported by veterinarians working in private versus corporate practices, we found several elements that may help explain the preference we found for private practice. Participants in private practice reported higher satisfaction with feeling known as an individual by upper management, hospital culture, the ability to fire difficult or abusive clients, and mentorship. In addition, those in corporate practices reported feeling more pressure than those in private practice to generate revenue and see more clients per shift. Together, these elements suggest that participants working in private practices feel more supported than their colleagues in corporate practices.

Importantly, these elements can have significant effects on veterinarians’ well-being and feelings of burnout. Previous studies have found that several items assessed in our study (eg, interpersonal work relationships, workload, work schedule, etc) are associated with burnout.26 Yet by their very nature, corporate practices have unique opportunities to implement wide-reaching systemic changes in these areas that can significantly impact the field of small animal practitioners by decreasing burnout and increasing job satisfaction.

Burnout, defined as a work-related syndrome characterized by emotional exhaustion, depersonalization, and a sense of reduced accomplishment resulting from chronic workplace stress,27,28 is a common problem in many healthcare professions2931 including veterinary medicine.26,3235 Burnout is associated with reduced productivity, high job turnover, and early retirement,36,37 affecting not only the mental health of veterinary professionals but the economic viability of hospitals.38 Primarily due to turnover and reduced working hours,39 the cost of burnout in annual lost revenue among veterinarians in the US has been estimated to be $1 billion to $2 billion.38 Distressingly, the prevalence of burnout appears to be increasing.40 In 1 recent study,35 87% of US veterinarians reported moderate to high burnout, and in the 2022 Merck Wellbeing study,41 31% of veterinarians reported high burnout, which was especially prevalent for veterinarians younger than 45 years of age. Furthermore, a recent AVMA study19 found that 40% of veterinarians are considering leaving the profession, with the top reasons including a lack of work-life balance and mental health challenges. Unfortunately, despite an increasing number of well-being resources available, fewer than 33% of veterinarians indicate accessing these types of resources.41 In our study, we found that participants in corporate settings were more likely to report having mental wellness programs and wellness mobile apps, but we did not inquire as to their usage. It is possible that although they have these benefits, they are unable or unwilling to access them.

While traditionally, the responsibility of managing burnout has been left to the individual veterinarian, and certainly individual choices and behaviors can decrease burnout and emotional stress,42 interventions at the organizational level have been found to be more effective at decreasing burnout among healthcare professionals29,30,4346 and should therefore be a top priority in veterinary medicine.47 There is growing evidence that workplace interventions solely targeting the individual may not be effective,48 suggesting the need for systemic changes in addition to individual-level intervention.43 Corporations, perhaps even better than privately owned hospitals, are well suited to implement systemic changes to combat burnout and other significant challenges within the field.

One fundamental component of systemic change includes assessing and, when necessary, changing hospital culture. Organizational culture is a dynamic, evolving collection of values, expectations, and practices that guide and inform the actions of all team members.49,50 A negative work culture is detrimental to all involved—the veterinary team, clients, and patients.51 There are several key elements in creating a healthy workplace culture, including good communication and fostering a strong sense of team and a high degree of trust.41 Part of good communication involves making sure people have a voice.29 Our study found that veterinarians working in private practice felt more satisfied that their voice was heard when compared to those working in corporate practice. Feeling listened to and having the ability to shape their hospital’s culture—including decisions about their jobs, hours, and tasks—are important to many veterinarians. Younger generations in particular prefer a democratic work structure and want to work at places where they feel that their opinions are wanted and valued.42 They gravitate to employment opportunities in which decisions are not made solely from the top down but instead are made from a more bottom-up and democratic system.52 Democratization in the workplace enhances employee commitment and reduces turnover.53

A focus on workplace culture offers a plethora of opportunities to implement organizational solutions to alleviate burnout. By focusing on individual, team, and environment factors, practices can reduce burnout and increase job satisfaction.54 Making these changes requires effective leadership. Good leadership is a key component to alleviating burnout and stress among employees.5557 The key elements of leadership that are important in improving morale and well-being include good communication skills; seeking suggestions and input pertaining to hospital culture and protocols; providing mentoring and frequent, timely feedback; and recognizing and rewarding quality job performance.57 To this end, we suggest that corporations focus on creating leadership training to help potential and current leaders improve and excel in these areas.

There were several limitations to this study. Our sample consisted of a small percentage of VIN members and the only demographics we collected were gender and graduation year, so caution is suggested when generalizing to other veterinarians since we cannot be certain that our sample represents the overall veterinary population. Moreover, because VIN membership is often a benefit offered by corporate-owned practices, this may have biased our results.

Potential response bias was another limitation. It is possible that individuals who feel strongly about corporate-owned practices, either positive or negative, might have been more likely to respond to the survey. Furthermore, because of the multitude of nuances within the categories “private” and “corporate” (eg, some single-doctor–owned practices are incorporated, some corporations are privately owned), it is possible that some participants may have been unclear as to what option to select. Additionally, we did not inquire about the usage of benefits, only whether they were received and the satisfaction level.

In summary, corporate-owned veterinary hospitals are quickly becoming the norm. There are pros and cons to corporate-owned hospitals when compared to privately owned practices, yet corporate hospitals are well suited to make instrumental changes on a large organizational level that can improve the lives of not only individual veterinarians but the overall well-being of the field of veterinary practitioners.

Supplementary Materials

Supplementary materials are posted online at the journal website: avmajournals.avma.org

Acknowledgments

None reported.

Disclosures

The authors have nothing to disclose. No AI-assisted technologies were used in the generation of this manuscript.

Funding

The authors have nothing to disclose.

References

  • 1.

    Kramer MH. Here’s a look at the pros and cons of corporate veterinary work. LiveAbout. Accessed May 29, 2023. https://www.liveabout.com/pros-and-cons-of-working-at-a-corporate-vet-clinic-125562

    • Search Google Scholar
    • Export Citation
  • 2.

    Gyles C. Corporate veterinary medicine. Can Vet J. 2014;55(6):515-518.

  • 3.

    Edling T. Corporate veterinary medicine. In: Ethics in Veterinary Practice. John Wiley and Sons Ltd; 2022:351368.

  • 4.

    Rothstein J. Corporate practices offer unique opportunities for your career. dvm360. 2022;53:52-52.

  • 5.

    CEOs of veterinary consolidators & hospital groups. CARE for Pets. Accessed June 3, 2023. https://www.pets.care/list-of-chief-executive-officers-of-veterinary-consolidators/

    • Search Google Scholar
    • Export Citation
  • 6.

    Carroll L. Veterinary practices are increasingly corporately owned, and pets owners pay the price. Observer. Accessed May 29, 2023. https://observer.com/2023/03/veterinary-practices-are-increasingly-corporately-owned-and-pets-owners-pay-the-price/

    • Search Google Scholar
    • Export Citation
  • 7.

    Petrova M. Unusual veterinarian statistics — the vet challenges of 2022. Pawsome Advice. Accessed May 29, 2023. https://pawsomeadvice.com/pets/veterinarian-statistics/

    • Search Google Scholar
    • Export Citation
  • 8.

    Corporate owned veterinarian clinic versus private practice. Independent Veterinary Practitioners Association. Accessed May 29, 2023. https://www.iveterinarians.org/corporate-owned-veterinarian-clinic-versus-private-practice-ivpa/

    • Search Google Scholar
    • Export Citation
  • 9.

    Big benefits: is it better to work for a corporation? DVM 360. Accessed May 29, 2023. https://www.dvm360.com/view/big-benefits-it-better-work-corporation

    • Search Google Scholar
    • Export Citation
  • 10.

    Ruiz PP. Current trends in veterinary medicine: a closer look at large-group consolidation. National Veterinary Professionals Union; 2019. Accessed March 15, 2023. https://www.natvpu.org/uploads/5/9/5/2/59529767/final_report_pablo_perez_ruiz__1_.pdf

    • Search Google Scholar
    • Export Citation
  • 11.

    Kidd S. Independent vs corporate veterinary practice. Platinum CPD. Accessed May 29, 2023. https://platinumcpd.com/independent-vs-corporate-veterinary-practice/

    • Search Google Scholar
    • Export Citation
  • 12.

    Smither S, Lauderdale F, Carlson R. Comparing corporate & private practice models. Veterinary Team Brief. Accessed March 15, 2023. https://www.cliniciansbrief.com/veterinary-team-brief

    • Search Google Scholar
    • Export Citation
  • 13.

    Dalton M, Hoyle DG, Watts MW. Human Relations. Cengage Learning; 2010.

  • 14.

    Mayo E. The Human Problems of an Industrial Civilization. Routledge; 2004.

  • 15.

    Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. The job demands-resources model of burnout. J Appl Psychol. 2001;86(3):499-512.

  • 16.

    Bakker AB, Demerouti E. The Job Demands-Resources model: state of the art. J Manag Psychol. 2007;22(3):309-328.

  • 17.

    Joshi A, Kale S, Chandel S, Pal D. Likert scale: explored and explained. Br J Appl Sci Technol. 2015;7(4):396-403.

  • 18.

    McHugh ML. The chi-square test of independence. Biochem Med (Zagreb). 2013;23(2):143-149.

  • 19.

    Larkin M. Veterinarian employers require innovative solutions to attract, retain staff members. AVMA News. Accessed May 29, 2023. https://www.avma.org/news/veterinarian-employers-require-innovative-solutions-attract-retain-staff-members

    • Search Google Scholar
    • Export Citation
  • 20.

    Feakes A, Lindsay N, Palmer E, Petrovski K. Business intentions of Australian veterinary students-my business or yours? A cluster analysis. Animals (Basel). 2023;13(7):1225.

    • Search Google Scholar
    • Export Citation
  • 21.

    Gates MC, McLachlan I, Butler S, Weston JF. Experiences of recent veterinary graduates in their first employment position and their preferences for new graduate support programmes. N Z Vet J. 2020;68(4):214-224.

    • Search Google Scholar
    • Export Citation
  • 22.

    Routly JE, Taylor IR, Turner R, McKernan EJ, Dobson H. Support needs of veterinary surgeons during the first few years of practice: perceptions of recent graduates and senior partners. Vet Rec. 2002;150(6):167-171.

    • Search Google Scholar
    • Export Citation
  • 23.

    Riggs EA, Routly JE, Taylor IR, Dobson H. Support needs of veterinary surgeons in the first few years of practice: a survey of recent and experienced graduates. Vet Rec. 2001;149(24):743-745.

    • Search Google Scholar
    • Export Citation
  • 24.

    Halliwell REW, Downes M, Adams VJ, et al. Stress in new graduates: can the profession do more to help? Vet Rec. 2016;178(25):635-636.

  • 25.

    Parker SC. Intrapreneurship or entrepreneurship? J Bus Ventur. 2011;26(1):19-34.

  • 26.

    Hayes GM, LaLonde-Paul DF, Perret JL, et al. Investigation of burnout syndrome and job-related risk factors in veterinary technicians in specialty teaching hospitals: a multicenter cross-sectional study. J Vet Emerg Crit Care (San Antonio). 2020;30(1):18-27.

    • Search Google Scholar
    • Export Citation
  • 27.

    Burn-out an “occupational phenomenon”: International Classification of Diseases. 2019. World Health Organization. Accessed June 1, 2023. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

    • Search Google Scholar
    • Export Citation
  • 28.

    Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-111.

    • Search Google Scholar
    • Export Citation
  • 29.

    Agarwal SD, Pabo E, Rozenblum R, Sherritt KM. Professional dissonance and burnout in primary care: a qualitative study. JAMA Intern Med. 2020;180(3):395-401.

    • Search Google Scholar
    • Export Citation
  • 30.

    De Simone S, Vargas M, Servillo G. Organizational strategies to reduce physician burnout: a systematic review and meta-analysis. Aging Clin Exp Res. 2021;33(4):883-894.

    • Search Google Scholar
    • Export Citation
  • 31.

    Patel RS, Bachu R, Adikey A, Malik M, Shah M. Factors related to physician burnout and its consequences: a review. Behav Sci (Basel). 2018;8(11):98.

    • Search Google Scholar
    • Export Citation
  • 32.

    Kogan L, Schoenfeld-Tacher R, Carney P, Hellyer P, Rishniw M. On-call duties: the perceived impact on veterinarians’ job satisfaction, well-being and personal relationships. Front Vet Sci. 2021;8:740852.

    • Search Google Scholar
    • Export Citation
  • 33.

    Kogan LR, Rishniw M, Hellyer PW, Schoenfeld-Tacher RM. Veterinarians’ experiences with near misses and adverse events. J Am Vet Med Assoc. 2018;252(5):586-595.

    • Search Google Scholar
    • Export Citation
  • 34.

    Kogan LR, Wallace JE, Schoenfeld-Tacher R, Hellyer PW, Richards M. Veterinary technicians and occupational burnout. Front Vet Sci. 2020;7:328.

    • Search Google Scholar
    • Export Citation
  • 35.

    Ouedraogo FB, Lefebvre SL, Hansen CR, Brorsen BW. Compassion satisfaction, burnout, and secondary traumatic stress among full-time veterinarians in the United States (2016-2018). J Am Vet Med Assoc. 2021;258(11):1259-1270.

    • Search Google Scholar
    • Export Citation
  • 36.

    Dewa CS, Loong D, Bonato S, Thanh NX, Jacobs P. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res. 2014;14(1):325.

    • Search Google Scholar
    • Export Citation
  • 37.

    Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-1385.

    • Search Google Scholar
    • Export Citation
  • 38.

    Neill CL, Hansen CR, Salois M. The economic cost of burnout in veterinary medicine. Front Vet Sci. 2022;9:814104.

  • 39.

    Han S, Shanafelt TD, Sinsky CA, et al. Estimating the attributable cost of physician burnout in the United States. Ann Intern Med. 2019;170(11):784-790.

    • Search Google Scholar
    • Export Citation
  • 40.

    Bain B, Ouedraogo FB, Radich R. 2020 Economic State of the Veterinary Profession. AVMA; 2020.

  • 41.

    Merck Animal Health Veterinary Wellbeing Study III. Merck Animal Health. Accessed March 15, 2023. https://www.merck-animal-health-usa.com/wp-content/uploads/sites/54/2022/02/2021-PSV-Veterinary-Wellbeing-Presentation_V2.pdf

    • Search Google Scholar
    • Export Citation
  • 42.

    Kofler I, Innerhofer E, Marcher A, et al. Shaping the future organization of work and life. In: Kofler I, Innerhofer E, Marcher A, et al., eds. The Future of High-Skilled Workers: Regional Problems and Global Challenges. Springer International Publishing; 2020:4557.

    • Search Google Scholar
    • Export Citation
  • 43.

    Panagioti M, Panagopoulou E, Bower P, et al. Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern Med. 2017;177(2):195-205.

    • Search Google Scholar
    • Export Citation
  • 44.

    Linzer M, Poplau S, Grossman E, et al. A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study. J Gen Intern Med. 2015;30(8):1105-1111.

    • Search Google Scholar
    • Export Citation
  • 45.

    Tawfik DS, Profit J, Webber S, Shanafelt TD. Organizational factors affecting physician well-being. Curr Treat Options Pediatr. 2019;5(1):11-25.

    • Search Google Scholar
    • Export Citation
  • 46.

    Sinsky CA, Biddison LD, Mallick A, et al. Organizational evidence-based and promising practices for improving clinician well-being. NAM Perspect. 2020;2020:10.31478/202011a.

    • Search Google Scholar
    • Export Citation
  • 47.

    Swensen S, Kabcenell A, Shanafelt T. Physician-organization collaboration reduces physician burnout and promotes engagement: the Mayo Clinic experience. J Healthc Manag. 2016;61(2):105-127.

    • Search Google Scholar
    • Export Citation
  • 48.

    Hilton KR, Burke KJ, Signal T. Mental health in the veterinary profession: an individual or organisational focus? Aust Vet J. 2023;101(1-2):41-48.

    • Search Google Scholar
    • Export Citation
  • 49.

    Tierney WG. Organizational culture in higher education. J Higher Educ. 1988;59:2-21.

  • 50.

    Alvesson M, Sveningsson S. Changing Organizational Culture: Cultural Change Work in Progress. Routledge; 2015.

  • 51.

    Hauser W. How is your hospital’s culture? Today’s Veterinary Business. Accessed May 29, 2023. https://todaysveterinarybusiness.com/how-is-your-hospitals-culture/

    • Search Google Scholar
    • Export Citation
  • 52.

    Mintzberg H. The strategy concept I: five Ps for strategy. Calif Manage Rev. 1987;30(1):11-24.

  • 53.

    Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated psychological problems. Asian J Psychiatr. 2020;51:102092.

    • Search Google Scholar
    • Export Citation
  • 54.

    Pizzolon CN, Coe JB, Shaw JR. Evaluation of team effectiveness and personal empathy for associations with professional quality of life and job satisfaction in companion animal practice personnel. J Am Vet Med Assoc. 2019;254(10):1204-1217.

    • Search Google Scholar
    • Export Citation
  • 55.

    Brower KJ. Organization-Level Interventions to Promote Physician Health and Well-Being: From Taking Care of Physicians to Giving Care to Patients. In: Brower KJ, Riba MB, eds. Physician Mental Health and Well-Being: Research and Practice. Integrating Psychiatry and Primary Care. Springer International Publishing; 2017:295323.

    • Search Google Scholar
    • Export Citation
  • 56.

    Shanafelt T, Swensen S. Leadership and physician burnout: using the annual review to reduce burnout and promote engagement. Am J Med Qual. 2017;32(5):563-565.

    • Search Google Scholar
    • Export Citation
  • 57.

    Shanafelt TD, Gorringe G, Menaker R, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015;90(4):432-440.

    • Search Google Scholar
    • Export Citation
  • 1.

    Kramer MH. Here’s a look at the pros and cons of corporate veterinary work. LiveAbout. Accessed May 29, 2023. https://www.liveabout.com/pros-and-cons-of-working-at-a-corporate-vet-clinic-125562

    • Search Google Scholar
    • Export Citation
  • 2.

    Gyles C. Corporate veterinary medicine. Can Vet J. 2014;55(6):515-518.

  • 3.

    Edling T. Corporate veterinary medicine. In: Ethics in Veterinary Practice. John Wiley and Sons Ltd; 2022:351368.

  • 4.

    Rothstein J. Corporate practices offer unique opportunities for your career. dvm360. 2022;53:52-52.

  • 5.

    CEOs of veterinary consolidators & hospital groups. CARE for Pets. Accessed June 3, 2023. https://www.pets.care/list-of-chief-executive-officers-of-veterinary-consolidators/

    • Search Google Scholar
    • Export Citation
  • 6.

    Carroll L. Veterinary practices are increasingly corporately owned, and pets owners pay the price. Observer. Accessed May 29, 2023. https://observer.com/2023/03/veterinary-practices-are-increasingly-corporately-owned-and-pets-owners-pay-the-price/

    • Search Google Scholar
    • Export Citation
  • 7.

    Petrova M. Unusual veterinarian statistics — the vet challenges of 2022. Pawsome Advice. Accessed May 29, 2023. https://pawsomeadvice.com/pets/veterinarian-statistics/

    • Search Google Scholar
    • Export Citation
  • 8.

    Corporate owned veterinarian clinic versus private practice. Independent Veterinary Practitioners Association. Accessed May 29, 2023. https://www.iveterinarians.org/corporate-owned-veterinarian-clinic-versus-private-practice-ivpa/

    • Search Google Scholar
    • Export Citation
  • 9.

    Big benefits: is it better to work for a corporation? DVM 360. Accessed May 29, 2023. https://www.dvm360.com/view/big-benefits-it-better-work-corporation

    • Search Google Scholar
    • Export Citation
  • 10.

    Ruiz PP. Current trends in veterinary medicine: a closer look at large-group consolidation. National Veterinary Professionals Union; 2019. Accessed March 15, 2023. https://www.natvpu.org/uploads/5/9/5/2/59529767/final_report_pablo_perez_ruiz__1_.pdf

    • Search Google Scholar
    • Export Citation
  • 11.

    Kidd S. Independent vs corporate veterinary practice. Platinum CPD. Accessed May 29, 2023. https://platinumcpd.com/independent-vs-corporate-veterinary-practice/

    • Search Google Scholar
    • Export Citation
  • 12.

    Smither S, Lauderdale F, Carlson R. Comparing corporate & private practice models. Veterinary Team Brief. Accessed March 15, 2023. https://www.cliniciansbrief.com/veterinary-team-brief

    • Search Google Scholar
    • Export Citation
  • 13.

    Dalton M, Hoyle DG, Watts MW. Human Relations. Cengage Learning; 2010.

  • 14.

    Mayo E. The Human Problems of an Industrial Civilization. Routledge; 2004.

  • 15.

    Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. The job demands-resources model of burnout. J Appl Psychol. 2001;86(3):499-512.

  • 16.

    Bakker AB, Demerouti E. The Job Demands-Resources model: state of the art. J Manag Psychol. 2007;22(3):309-328.

  • 17.

    Joshi A, Kale S, Chandel S, Pal D. Likert scale: explored and explained. Br J Appl Sci Technol. 2015;7(4):396-403.

  • 18.

    McHugh ML. The chi-square test of independence. Biochem Med (Zagreb). 2013;23(2):143-149.

  • 19.

    Larkin M. Veterinarian employers require innovative solutions to attract, retain staff members. AVMA News. Accessed May 29, 2023. https://www.avma.org/news/veterinarian-employers-require-innovative-solutions-attract-retain-staff-members

    • Search Google Scholar
    • Export Citation
  • 20.

    Feakes A, Lindsay N, Palmer E, Petrovski K. Business intentions of Australian veterinary students-my business or yours? A cluster analysis. Animals (Basel). 2023;13(7):1225.

    • Search Google Scholar
    • Export Citation
  • 21.

    Gates MC, McLachlan I, Butler S, Weston JF. Experiences of recent veterinary graduates in their first employment position and their preferences for new graduate support programmes. N Z Vet J. 2020;68(4):214-224.

    • Search Google Scholar
    • Export Citation
  • 22.

    Routly JE, Taylor IR, Turner R, McKernan EJ, Dobson H. Support needs of veterinary surgeons during the first few years of practice: perceptions of recent graduates and senior partners. Vet Rec. 2002;150(6):167-171.

    • Search Google Scholar
    • Export Citation
  • 23.

    Riggs EA, Routly JE, Taylor IR, Dobson H. Support needs of veterinary surgeons in the first few years of practice: a survey of recent and experienced graduates. Vet Rec. 2001;149(24):743-745.

    • Search Google Scholar
    • Export Citation
  • 24.

    Halliwell REW, Downes M, Adams VJ, et al. Stress in new graduates: can the profession do more to help? Vet Rec. 2016;178(25):635-636.

  • 25.

    Parker SC. Intrapreneurship or entrepreneurship? J Bus Ventur. 2011;26(1):19-34.

  • 26.

    Hayes GM, LaLonde-Paul DF, Perret JL, et al. Investigation of burnout syndrome and job-related risk factors in veterinary technicians in specialty teaching hospitals: a multicenter cross-sectional study. J Vet Emerg Crit Care (San Antonio). 2020;30(1):18-27.

    • Search Google Scholar
    • Export Citation
  • 27.

    Burn-out an “occupational phenomenon”: International Classification of Diseases. 2019. World Health Organization. Accessed June 1, 2023. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

    • Search Google Scholar
    • Export Citation
  • 28.

    Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-111.

    • Search Google Scholar
    • Export Citation
  • 29.

    Agarwal SD, Pabo E, Rozenblum R, Sherritt KM. Professional dissonance and burnout in primary care: a qualitative study. JAMA Intern Med. 2020;180(3):395-401.

    • Search Google Scholar
    • Export Citation
  • 30.

    De Simone S, Vargas M, Servillo G. Organizational strategies to reduce physician burnout: a systematic review and meta-analysis. Aging Clin Exp Res. 2021;33(4):883-894.

    • Search Google Scholar
    • Export Citation
  • 31.

    Patel RS, Bachu R, Adikey A, Malik M, Shah M. Factors related to physician burnout and its consequences: a review. Behav Sci (Basel). 2018;8(11):98.

    • Search Google Scholar
    • Export Citation
  • 32.

    Kogan L, Schoenfeld-Tacher R, Carney P, Hellyer P, Rishniw M. On-call duties: the perceived impact on veterinarians’ job satisfaction, well-being and personal relationships. Front Vet Sci. 2021;8:740852.

    • Search Google Scholar
    • Export Citation
  • 33.

    Kogan LR, Rishniw M, Hellyer PW, Schoenfeld-Tacher RM. Veterinarians’ experiences with near misses and adverse events. J Am Vet Med Assoc. 2018;252(5):586-595.

    • Search Google Scholar
    • Export Citation
  • 34.

    Kogan LR, Wallace JE, Schoenfeld-Tacher R, Hellyer PW, Richards M. Veterinary technicians and occupational burnout. Front Vet Sci. 2020;7:328.

    • Search Google Scholar
    • Export Citation
  • 35.

    Ouedraogo FB, Lefebvre SL, Hansen CR, Brorsen BW. Compassion satisfaction, burnout, and secondary traumatic stress among full-time veterinarians in the United States (2016-2018). J Am Vet Med Assoc. 2021;258(11):1259-1270.

    • Search Google Scholar
    • Export Citation
  • 36.

    Dewa CS, Loong D, Bonato S, Thanh NX, Jacobs P. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res. 2014;14(1):325.

    • Search Google Scholar
    • Export Citation
  • 37.

    Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-1385.

    • Search Google Scholar
    • Export Citation
  • 38.

    Neill CL, Hansen CR, Salois M. The economic cost of burnout in veterinary medicine. Front Vet Sci. 2022;9:814104.

  • 39.

    Han S, Shanafelt TD, Sinsky CA, et al. Estimating the attributable cost of physician burnout in the United States. Ann Intern Med. 2019;170(11):784-790.

    • Search Google Scholar
    • Export Citation
  • 40.

    Bain B, Ouedraogo FB, Radich R. 2020 Economic State of the Veterinary Profession. AVMA; 2020.

  • 41.

    Merck Animal Health Veterinary Wellbeing Study III. Merck Animal Health. Accessed March 15, 2023. https://www.merck-animal-health-usa.com/wp-content/uploads/sites/54/2022/02/2021-PSV-Veterinary-Wellbeing-Presentation_V2.pdf

    • Search Google Scholar
    • Export Citation
  • 42.

    Kofler I, Innerhofer E, Marcher A, et al. Shaping the future organization of work and life. In: Kofler I, Innerhofer E, Marcher A, et al., eds. The Future of High-Skilled Workers: Regional Problems and Global Challenges. Springer International Publishing; 2020:4557.

    • Search Google Scholar
    • Export Citation
  • 43.

    Panagioti M, Panagopoulou E, Bower P, et al. Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern Med. 2017;177(2):195-205.

    • Search Google Scholar
    • Export Citation
  • 44.

    Linzer M, Poplau S, Grossman E, et al. A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study. J Gen Intern Med. 2015;30(8):1105-1111.

    • Search Google Scholar
    • Export Citation
  • 45.

    Tawfik DS, Profit J, Webber S, Shanafelt TD. Organizational factors affecting physician well-being. Curr Treat Options Pediatr. 2019;5(1):11-25.

    • Search Google Scholar
    • Export Citation
  • 46.

    Sinsky CA, Biddison LD, Mallick A, et al. Organizational evidence-based and promising practices for improving clinician well-being. NAM Perspect. 2020;2020:10.31478/202011a.

    • Search Google Scholar
    • Export Citation
  • 47.

    Swensen S, Kabcenell A, Shanafelt T. Physician-organization collaboration reduces physician burnout and promotes engagement: the Mayo Clinic experience. J Healthc Manag. 2016;61(2):105-127.

    • Search Google Scholar
    • Export Citation
  • 48.

    Hilton KR, Burke KJ, Signal T. Mental health in the veterinary profession: an individual or organisational focus? Aust Vet J. 2023;101(1-2):41-48.

    • Search Google Scholar
    • Export Citation
  • 49.

    Tierney WG. Organizational culture in higher education. J Higher Educ. 1988;59:2-21.

  • 50.

    Alvesson M, Sveningsson S. Changing Organizational Culture: Cultural Change Work in Progress. Routledge; 2015.

  • 51.

    Hauser W. How is your hospital’s culture? Today’s Veterinary Business. Accessed May 29, 2023. https://todaysveterinarybusiness.com/how-is-your-hospitals-culture/

    • Search Google Scholar
    • Export Citation
  • 52.

    Mintzberg H. The strategy concept I: five Ps for strategy. Calif Manage Rev. 1987;30(1):11-24.

  • 53.

    Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated psychological problems. Asian J Psychiatr. 2020;51:102092.

    • Search Google Scholar
    • Export Citation
  • 54.

    Pizzolon CN, Coe JB, Shaw JR. Evaluation of team effectiveness and personal empathy for associations with professional quality of life and job satisfaction in companion animal practice personnel. J Am Vet Med Assoc. 2019;254(10):1204-1217.

    • Search Google Scholar
    • Export Citation
  • 55.

    Brower KJ. Organization-Level Interventions to Promote Physician Health and Well-Being: From Taking Care of Physicians to Giving Care to Patients. In: Brower KJ, Riba MB, eds. Physician Mental Health and Well-Being: Research and Practice. Integrating Psychiatry and Primary Care. Springer International Publishing; 2017:295323.

    • Search Google Scholar
    • Export Citation
  • 56.

    Shanafelt T, Swensen S. Leadership and physician burnout: using the annual review to reduce burnout and promote engagement. Am J Med Qual. 2017;32(5):563-565.

    • Search Google Scholar
    • Export Citation
  • 57.

    Shanafelt TD, Gorringe G, Menaker R, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015;90(4):432-440.

    • Search Google Scholar
    • Export Citation

Advertisement