A new commentary in the Journal of the American Animal Hospital Association asks a question that's been building for years in vet med: as corporate consolidation accelerates, who actually belongs in the leadership seat?

The JAAHA Special Commentary by Joe Hill, BSc, BVSc, MBA, MRCVS, titled "The Growing Tension Between Clinical Expertise and Corporate Consolidation in Veterinary Medicine," examines how the shift toward private equity ownership and corporate group management is reshaping the profession, and whether it's doing so at a cost.

The article, summarized in AAHA Trends, draws on Dr. Hill's personal experience and evidence from both veterinary and human healthcare to make a pointed argument: organizations in clinical fields tend to struggle when financial decision-makers are structurally disconnected from the people delivering care.

What the Research Shows

Dr. Hill examines a pattern that will feel familiar to many veterinary professionals: as consolidation increases, burnout rises, workforce dissatisfaction grows, and the gap between executive decisions and frontline reality widens.

When clinicians are meaningfully represented in leadership, patient outcomes tend to improve and staff retention improves alongside them. When they aren't, practices can find themselves optimizing for metrics that don't map onto what the team on the floor is actually experiencing.

The commentary doesn't argue corporate ownership is inherently bad; it asks what conditions let it coexist with clinical excellence over the long term.

Why This Matters Right Now

Vet med is in the middle of a consolidation wave that shows no signs of slowing. For individual practices and for the professionals working in them, the structural decisions being made at the ownership level have real downstream effects on day-to-day work, on culture, on scheduling, on whether a team feels like a team.

There's a reason retention keeps surfacing as the defining challenge in the profession. It isn't only about pay, although compensation matters. It's about whether people feel like they belong to something with a clear sense of purpose, and whether leadership understands what they do.

Dr. Hill's commentary advocates for stronger clinician representation in leadership roles, greater investment in workforce wellbeing, and long-term strategies that treat patient care and financial sustainability as complementary rather than competing goals. That's a hard balance to strike, but it's the right one to aim for.

What Practice Leaders Can Do

  • Name it, then build toward it. If your practice has gone through an acquisition or ownership change, or is considering one, it's worth asking explicitly: who has clinical representation at the table when decisions get made? That representation doesn't need to be a title. It can be a structured communication channel, a standing check-in with clinical staff before policy changes land, a leadership team that genuinely understands what a 10-hour shift looks like.
  • Culture doesn't survive on intent alone. The commentary makes clear that burnout and dissatisfaction track closely with the feeling that leadership decisions are disconnected from clinical reality. Culture requires active maintenance, not just stated values. For independent practices, that's a genuine advantage: you have the proximity and flexibility to course-correct quickly. Protect it.
  • Treat clinician leadership as an investment, not a cost. The practices that will navigate this period well are the ones that figure out how to keep their best people, and that starts with giving those people a genuine stake in how the practice runs. Whether that's a formal leadership track, a structured mentorship program, or simply being asked what they think before decisions are made, the signal matters.

The consolidation of veterinary medicine isn't slowing down. But the commentary's argument stands: the profession's long-term strength depends on giving clinical expertise a seat in setting direction, not only in carrying it out.