VHMA Insiders' Insight Commentary
July 2026
Brittany Yost, CVPM, CVBL, CCFP
Director, Customer Implementation and Engagement, Vetsource
This month’s VHMA Insiders' Insight dashboard tells a familiar story. Revenue continues to grow (+2.7%), driven primarily by higher revenue per patient (+4.2%), even as patient visits (-0.6%), active patient counts, and new client acquisition remain below last year's levels. None of these trends are entirely new. We've been watching many of them develop over the past several years. What continues to change, however, is not just the performance of our practices, but the expectations placed on the people leading them. As the operational challenges facing veterinary hospitals become more complex, so does the role of the practice manager.
The Job Description Nobody Updated
When many of us entered this profession, the expectations were relatively clear. Practice managers were responsible for keeping the hospital running. We managed schedules, handled payroll, ordered inventory, coordinated hiring, addressed facility issues, and solved the dozens of operational challenges that arise on any given day. Those responsibilities haven't disappeared. If anything, veterinary hospitals have become more complex, not less. But somewhere along the way, the job quietly expanded. Practice managers are no longer expected to simply keep the business running. They're increasingly expected to help determine how it performs.
Hospital owners and leadership teams are asking bigger questions than they were five or ten years ago. Why is doctor productivity declining? Why has revenue growth slowed? Why are clients not following through with recommendations? Why is the team feeling overwhelmed despite having more staff? Why do some hospitals consistently outperform others despite having access to the same tools and resources? These aren't administrative questions; they're operational questions. And more often than not, they're landing on the practice manager's desk.
I've recently had several conversations with managers at a local specialty/ER hospital. What stuck out to me is that they rarely spend the majority of their day focused on payroll or inventory counts. Instead, they're evaluating workflows, analyzing reports, implementing new technology, coaching teams, and trying to identify opportunities for improvement. In many ways, they've become operational strategists, whether anyone officially changed their job description or not.
The Thinking is Changing
Consider appointment availability. Historically, if a doctor was booked out for several weeks, the assumption might have been that the hospital simply needed another veterinarian. Sometimes that's true, but today's practice managers are digging deeper. Is the appointment schedule structured appropriately? Are credentialed technicians being utilized at the top of their license? Are doctors spending time on tasks that could be delegated? Are workflow bottlenecks reducing capacity? The difference is subtle but important. The focus has shifted from managing the symptom to understanding the system.
I see a similar evolution happening around data. Not long ago, many managers were expected to review reports and monitor key metrics. Today, leaders are expected to interpret what those metrics mean and translate them into action. Revenue is up. Why? Patient visits are down. Why? Compliance rates have changed. Why? The data itself isn't the answer. It's the starting point for asking better questions.
The Role is Expanding
Perhaps the most significant change, however, is that practice managers are increasingly being asked to influence outcomes that extend far beyond traditional operations. They're being asked to address things like client retention, team engagement, technology adoption, workflow efficiency, and practice growth. These areas require strategic thinking, cross-functional collaboration, and a willingness to challenge existing processes. Success often depends less on maintaining the status quo and more on continuously improving it.
The reality is that veterinary medicine is becoming more sophisticated. Client expectations continue to evolve. Technology is advancing rapidly. Financial pressures remain real. At the same time, hospitals are generating more data than ever before. Someone has to connect all of those moving pieces, and more often, that someone is the practice manager.
The Skills Can Be Learned
One of the encouraging aspects of this shift is that most of these skills can be developed. Very few practice managers entered the profession with formal training in business analytics, workflow design, change management, or strategic planning. Most of us learned by doing. We solved problems as they appeared, adapted to new challenges, and built our expertise one experience at a time. The same can be true of this next evolution.
For some, that growth may come through continuing education, industry conferences, and professional certifications. For others, it may come from becoming more curious about the data behind hospital performance, seeking opportunities to participate in strategic discussions, or simply asking "why" more often when evaluating existing processes.
One of the most valuable habits I've observed in successful leaders is a willingness to look beyond the immediate problem and explore the system behind it. Instead of asking, "How do we fix this?" they ask, "Why is this happening in the first place?" That mindset shift alone can transform the way we lead.
Organizations like the VHMA play an important role in this journey. Beyond providing resources and education, they create opportunities for practice leaders to learn from one another, share challenges, and gain exposure to new ways of thinking about hospital operations. In a profession that continues to evolve, those connections and perspectives may be just as valuable as any individual skill we develop.
The good news is that veterinary medicine doesn't need practice managers who have all the answers. It needs leaders who are willing to keep learning, remain curious, and embrace a role that is becoming increasingly influential in the success of the hospital.
Closing Thought
I don't believe this shift diminishes the importance of the traditional management skills that have always been essential to running a successful hospital. Strong administrative leadership remains the foundation. Hospitals still need leaders who can manage people, solve problems, and keep daily operations running smoothly, but the role is expanding.
The most impactful practice managers I've encountered aren't just managing schedules or balancing budgets. They're identifying inefficiencies, improving workflows, analyzing trends, guiding change, and helping shape the future direction of their hospitals. They're not simply running the business; they're helping determine how the business performs. As our profession continues to evolve, I believe we'll increasingly see practice managers recognized not only as operational leaders, but as strategic partners whose influence extends well beyond the day-to-day functions of the hospital. Perhaps that's the biggest shift of all. Practice managers aren't just keeping hospitals running anymore. They're helping shape where they go next.
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