Outside the Box

The biggest obstacle to an entrepreneurial life may be thinking that the box exists at all.

Dr. Andrew Clark, DVM, MBA, former clinical equine practitioner and now veterinary consultant, helped frame the issue of veterinarians as entrepreneurs and the mindset required for a successful transition when he relayed the words of one of the faculty members from his MBA program.

Someone asked the instructor about the concept of “thinking outside the box.” The faculty member replied, “There is no box. There is only thinking. The box is something we put over our heads to keep from being confused.” Eliminating the box opens the horizon to a world of creative thinking.

Equine practice in most cases is an entrepreneurial venture, especially when it relates to solo practice or the practice owner’s role in a group practice. This piece will seek to examine possibilities and potential roles for equine veterinarians beyond this core entrepreneurship—going beyond the bounds of creating a successful clinical practice.

Veterinarian as Inventor
One of the earliest veterinarian-inventors who thought totally out of the box created an item that is still important in our daily lives nearly 150 years later. Robert Dunlop, a Scottish veterinarian practicing in Belfast, Ireland, developed one of the first pneumatic tires, experimenting with his son’s tricycle, using layers of rubber. His tires became popularized as cyclist Willie Hume racked up an impressive record of victories in cycling races in 1889.

Although Dunlop had been granted a patent for his tire in 1888, it was invalidated two years later. Nonetheless, he is credited with the tire technology that still endures today, and the company that carries his name continues to produce tires worldwide. Dunlop is honored on the Northern Ireland 10 pound note.

Veterinarians are theoretically well-suited for second careers as entrepreneurs by virtue of their broad-based educational background and often independent personalities.

Unfortunately, the reality of practice life often clashes with the optimum environment for nurturing potentially risky business ventures, stacking the odds against many practicing veterinarians.

Nonetheless, some veterinarians, particularly practice owners who employ other veterinarians, have the financial stability and can create the time to succeed in the entrepreneurial arena, most often in areas that relate to practice expansion, practice management tools, and clinical improvements. Similar opportunities might be waiting for other veterinarians to discover.

Other veterinarians are forced into an entrepreneurial role—whether by injury, as was the case in Clark’s situation, or circumstance, as many find themselves today due to the financial pressures in this constricted economy. As Clark points out, there are 915 resumes on file with the American Association of Equine Practitioners, while only 17 positions are currently listed. This mismatch forces veterinarians to search elsewhere to survive.


An internet search for “characteristics of a successful entrepreneur” resulted in a plethora of so-called essentials: Do what you enjoy. Follow your dream. Take your business seriously. Be willing to take the risk. Plan everything carefully. Manage money wisely. Ask for the sale. Sell to survive and prosper. Sell the benefits you offer. Take care of your customers.

Get to know your customers. Be accessible. Be persistent. Communicate constantly. Follow up incessantly. Get involved in your community. Grab attention. Promote yourself. Build a rock-solid reputation. Project a positive business image. Build a top business team. Hire the right employees. Value your employees. Establish a winning culture. Become an expert. Invest in yourself. Call upon mentors. Create a competitive advantage. Leverage your use of technology. Master the art of negotiation. Design your workspace for success. Get and stay organized. Limit the number of hats you wear. Take time off.

Other columnists point out the personality traits that they say typify the successful entrepreneur: self-motivation, creativity, intuition, authoritative manner and strong will.

Some of these mirror closely the qualities that also contribute to the successful veterinarian.

According to a column written by Kim Kiser in the April 2007 edition of Minnesota Medicine, there are six important sets of skills and abilities that relate to a prospective veterinary student’s likelihood to succeed in the veterinary profession. These characteristics were described by Personnel Decisions International (PDI), a Minneapolis-based consulting firm hired to advise a consortium of veterinary schools on how to better select those students most likely to succeed. Many of these characteristics track closely with requirements for a successful entrepreneur and include:

· self-management (the ability to act autonomously and with confidence)

· leadership (the ability to direct and motivate others, to act as a coach)

· critical thinking (the ability to think creatively and use soundjudgment)

· communication (being able to write and speak clearly and to listen carefully)

· relationship-building (the ability to show care and concern for others)

· business skills (understanding what it takes to successfully run a practice)

PDI also advised that students be evaluated for “nontechnical competencies” that relate to how successfully veterinarians will be able to deal with the following challenges:

1. understanding the business of veterinary practice
2. keeping up with scientific knowledge and technical skills
3. managing people and processes
4. satisfying customers
5. achieving a balance between work and life

Apparently, the traits predictive of a successful entrepreneur parallel those of a successful veterinarian on many levels, but how on earth can one human balance two demanding careers and still follow those last rules: time off and a balance between work and life?

Balancing time for a personal life often falls somewhere between challenging and impossible, let alone finding time to launch an additional business venture.

The Financial Incentive
Finances also enter into the picture. The average new graduate is likely to be encumbered by substantial educational debt—$133,000, according to AVMA’s recent estimate—and likely to receive a salary that averages approximately $48,600. Those figures do not leave much reserve capital available for investment in a potentially risky venture.

With the contracted economy, veterinary school graduates appear to be receiving fewer job offers per graduate, a factor which may play both sides of the entrepreneurial equation. Those seeking stable, traditional clinical jobs may hold them more dearly, cognizant of the competition eagerly waiting to replace them. Difficulty in landing a conventional practice post may propel other graduates to throw themselves down nontraditional paths, where they may succeed or fail based upon their own resourcefulness and abilities.

Lots of misconceptions are floating around regarding what makes a successful entrepreneur. The blog from the website Pop Economics (www.popeconomics.com) discusses research that debunks some myths enshrouding the successful entrepreneur. First, entrepreneurs don’t necessarily seek risk, but they accept it. A University of Illinois study found that entrepreneurs are not inherently more risk-seeking than members of the general population.

The blogger qualifies his remarks, stating, “That’s not to say that entrepreneurs are unaware of risk. In fact, successful ones tend to spread it out amongst other founders and investors so that even if a bad event happens, they won’t be the only ones bearing the brunt of the pain.”

Pop Economics also tackles what it takes to be a successful entrepreneur. The ability to handle ambiguity “without freaking out” is one trait that does set them apart from the general population. Surprisingly, despite romantic misconceptions, most entrepreneurs that top $1 million in sales are closer to 40 years old than they are to 20, and have graduated from college, often with advanced degrees. They are more likely to be generalists than specialists, according to an analysis by Stanford Professor Edward Lazear. Finally, they are excellent team builders.

Close to Home
Turning the focus to equine practice, veterinarians have been extremely successful in entrepreneurial ventures that relate directly the business of veterinary medicine. Equine mega-practices like the Hagyard Equine Medical Institute and Rood and Riddle have developed into large corporations that offer traditional veterinary medical services, specialists and referral care and have expanded to serve external veterinarians’ needs in custom pharmaceutical compounding, educational opportunities for veterinarians as well as clients, and ancillary services including podiatry and farrier services, imaging and the development of stem-cells for therapies.

Most equine veterinarians practice in far less specialized environments. More than 50 percent of all practices are still staffed by solo veterinarians who must be “jacks-of-all-trades,” although the number of practices with more than four equine veterinarians has grown to comprise more than 20 percent of the profession. In order to scratch the entrepreneurial itch, solo practitioners might gravitate more toward practice management, and veterinary business systems development, joining clusters of practices under a single practice umbrella, as veterinarian Mike Pownall has done in Canada with McKee-Pownall Veterinary Services. Systems developed to better manage companion animal hospitals may translate readily to their equine practice cousins, requiring a few tweaks here or there.

According to Clark, a clinical veterinary practitioner may listen more readily to practice management advice coming from a fellow veterinarian, rather than from someone who is simply a business consultant. He relates, “I have done the arthroscopy, the embryo transfer, the other procedures common to daily equine practice. This gives me the advantage of ‘street cred’—so I am able to come in and share my experience with the managing partners, and they had confidence that when I said they could do something, that they actually could do it. Previous consultants may have said the same thing, but the practice members might be willing to try an extra little bit harder because I am one of them.”

As veterinarians develop their solo practices, they may find opportunities to expand their reach by adding clinical practitioners, or to pursue particular interests by adding specialists or ancillary services. Some have broadened their scope by working closely with farriers, equine massage therapists, nutrition specialists, or other practitioners who offer complementary therapies such as veterinary acupuncture or veterinary chiropractic services, and may even offer appointments with these other professionals at their own clinics at regular intervals. Some are working to recapture practice areas that may not have seemed so important during the “golden years” of equine practice; dentistry and equine reproductive services are examples in this direction.

Dr. Dennis Rach, a large animal practitioner with Moore and Co. Veterinary Services in Calgary, Alberta, Canada, designed a series of rotary equine instruments in the 1980s to improve the level of dental care he could offer to his equine patients. One of them, a motorized floating device with a right-angle design, offered exemplary performance. He refined the invention with the assistance of local machinists over the next several years. He patented the device as the PowerFloat and introduced it to the broader veterinary community in 2000. Rach continues to improve and refine his design and to add additional instruments to the PowerFloat line of dental tools.

Veterinarians often have extensive educational background in related fields prior to their entrance into veterinary school. Some pursue additional advanced degrees either before or after they receive their DVM or VMD. These individuals may draw upon their other backgrounds as they develop their careers. A veterinarian-attorney may spend several years gaining clinical practice experience, and then begin to draw upon his or her non-veterinary skills to offer consultancy at the intersection of law and veterinary medicine. Veterinarians with specialized laboratory or technical backgrounds may invent techniques and diagnostic equipment in the laboratory, perhaps in conjunction with the practitioner in the field, which may lead to opportunities as these technologies are commercialized.

Other areas of veterinary medicine may offer examples for equine veterinarians to follow. Trends prominent in companion animal practice today may become tomorrow’s trends in equine medicine. For the more farsighted, trends in human medicine this year may even become ripe for commercial application to horses five, 10 or 20 years down the line.
Inventors of the FLAIR Equine Nasal Strip, Drs. Jim Chiapetta DVM, JD and Edward Blach, DVM, MS, MBA, drew freely upon the Breathe Right Nasal Strips, a breathing aide well-established in human medicine, to develop their technology, geared to help treat exercised-induced pulmonary hemorrhage in horses without the use of drugs. They relate their story on their website:

“In the mid 1990s, we wondered if it was possible to improve air flow in the horse by applying an external nasal passage support similar to the BreatheRight strip used by human athletes. Our review of the equine research literature revealed a void in the knowledge regarding the role of the nasal passages in the horses’ breathing and respiratory health. When we initially proposed our theory to veterinarians, many responded that such a support would not work because of the unique nasal anatomy of the horse … some equine respiratory experts scoffed at our challenge to traditional beliefs about equine respiratory physiology and the cause of bleeding. In fact, one of our biggest obstacles to pursuing the development of nasal strips was our own veterinary training that the throat was the primary site of resistance to breathing in the horse.”

Nonetheless, they continued to seek a solution, and now point to multiple clinical studies that support their original hypotheses. They have been awarded more than 15 U.S. and international patents supporting their work, and have seen their FLAIR Strips adapted for regular use by top-class racehorses and competitors in equine sports, as well as by amateur horse owners.

Equine veterinarians looking for entrepreneurial opportunities should also look outside the profession to see where others may have capitalized on areas that could be equally populated by veterinarians. Equine reproduction obviously comes to mind. Farm animal reproduction is an area that has traditionally been the realm of animal scientists and in many cases, technicians who have been willing to travel to the farms. Although many veterinarians have developed tremendous capability and services in this area, some of the most successful establishments are owned and operated by non-veterinarians who employ veterinarians to do the work where a medical license is required.

Select Breeders Services, founded by animal scientist Paul Loomis, is the umbrella organization for multiple member labs throughout North America, many of which are resident in veterinary practices. Breeders regularly consult knowledgeable but non-veterinary sources for resource information on equine reproduction, and take training in basic equine reproduction practices. As reproductive technologies advance, so will opportunities related to cloning and the custom-design of the foals that breeders seek to produce.

Services used by horse-owning clients may also offer other opportunities, such as the “wellness” programs now commonly offered by many equine veterinarians. Others run parallel with the lifecycle of the horse. Dr. Robert Miller influenced a generation of horsemen with his guidance on handling of the young foal. Behavior and training are issues that horse owners and veterinarians confront throughout the life of the horse. Equine athletes require special care and handling, and the development of supportive equipment and indicators of performance and health for the elite offer opportunities for veterinarians and lay people alike. Innovations in training equipment that relate to orthopedics and the comfort of the horse add another layer of opportunity. As the horse ages, veterinarians may find opportunities in dealing with final stages of a horse’s life, including the potential provision of cremation or other carcass disposal services.

Inspiration for the veterinarian-entrepreneur lurks around every corner, but the average practitioner may be too insulated to notice until they are forced to do so. Clark views entrepreneurial opportunities as fertile ground for collaboration more than competition, enabling veterinarians to bring together colleagues with varying specialized areas of expertise to work together toward improving practice. He finds today’s graduates perhaps better equipped to take advantage of “thinking without the box,” pointing out that veterinarians “can be resourceful and entrepreneurial and we can do some things we didn’t think we could do.”

Clark likes to quote Jack Welch, former CEO of General Electric, who cautioned, “Face reality as it is, not as it was or as you wish it to be.” Advice from Clark: “Look for opportunities where you don’t expect them. Depending on your passion and your skill set, there are things you can do that never occurred to you. If you look for opportunity instead of despair, you will probably find it.”

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