A new commentary in the Journal of the American Animal Hospital Association (JAAHA) argues that veterinary medicine's leadership seats belong to clinicians, not just financial decision-makers, because organizations in clinical fields consistently struggle when the two are structurally disconnected.
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.
Drawing on personal experience and evidence from both veterinary and human healthcare, as summarized in AAHA Trends, Dr. Hill makes 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, effects staff and clients describe firsthand once a practice actually changes hands.
There's a reason retention keeps surfacing as the defining challenge in the profession. Pay matters, but what the data keeps pointing to is something harder to fix: 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.
Where Clinician Representation Starts
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.
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.
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: a formal leadership track, a structured mentorship program, or simply being asked what they think before decisions are made. The consolidation of veterinary medicine isn't slowing down, which makes the case for clinical expertise at the leadership table stronger with every passing quarter.