Learn from many. Shape your way forward.
The best veterinary leaders learn from many sources, study what worked, what failed, and why, then decide what makes sense for their patients, people, and practice.
Success Stories Rarely Show the Whole Picture
Long before veterinary school, I learned to ask why a business idea worked in one setting and failed in another. My dad was a serial small-business entrepreneur, so I grew up around new ventures, setbacks, restarts, and the occasional win. I learned as much from his misses as his successes because both showed that outcomes depend on more than the idea itself.
When I opened my veterinary clinic in 1993, only 14 months after graduating, I set out to learn from people willing to share their real-world experience. I read everything I could find, attended sales and leadership meetings (thank you, Zig Ziglar!), and built relationships with successful local business owners, a few of whom became close friends. I also studied every word of Veterinary Economics, sought out established veterinarians who were willing to share their time, and reviewed business and accounting textbooks.
Popular growth tactics back then included "free vaccines with an exam," heavy service discounts, and fee matching to attract and retain clients. Medically, the prevailing model was "fire truck medicine": wait for a problem, rush in to put it out, and then wait for the next one.
The leaders promoting these ideas had built successful practices, and their teachings deserved respect. The facts and revenue showed that their methods could work. They did not prove that those methods were the only path or the best match for my practice.
Their examples taught me to diagnose my own challenges, understand what made their methods succeed or fail, and choose a direction for my practice.
I never agreed with free vaccines and discounts, so I never offered them. In fact, I did the opposite. I canvassed surrounding clinics, set our general exam fee $1 above the prevailing local fee, and applied a modest premium across the board.
My team of two emphasized thorough client communication and comprehensive physical examinations. Clients took home a written report, which was unheard of at the time. We also focused on preventive medicine, nutrition and weight management, and behavior and training.
We invested early in technology. Computerized practice-management software was still the exception, not the rule, and our digital ECG system even provided measurements (wow!). We added an in-clinic CBC system that still required manual differentials and, later, chemistry analyzers and other diagnostics.
Our "high-tech, high-touch" approach paired a high standard of medicine and technology with exceptional communication and personal service. Instead of asking, "How can we be cheaper?" we asked, "How can we deliver care worth paying more for?"
A recent Bloomberg Businessweek article about leaders who declined well-intentioned guidance brought that distinction back to me. Management researcher Jerker Denrell's work on the "undersampling of failure" explains why copying success stories can mislead us: the organizations and attempts that failed are less likely to remain available for study.
A Pay System Cannot Do a Leader's Job
I recently heard a veterinarian involved with a corporate practice describe his frustrating search for a compensation model that worked. His group had moved from production-based pay to salary and then back to production. He believed his veterinarians responded better to production incentives. He didn't like feeling that he had to "lead with money," but he saw no better option.
As he spoke, I kept waiting to hear about everything surrounding the pay model. How did leaders set expectations, coach performance, recognize contributions, and respond when performance slipped? What did the culture and total package offer? At least in the account I heard, those questions barely appeared. Compensation was treated as both the problem and the solution for his veterinarians' motivation. He concluded that production-based pay was the best fit for his practice. My experience led me to a different conclusion.
I have long favored salary-based compensation. In the 1990s, I was influenced partly by Mayo Clinic's structured, salary-only physician model. As Mayo expanded its clinics nationwide, it exposed an entire generation to that pay model.
But salary alone did not make either Mayo's approach or ours work. We paid above the regional average for every position, regularly asked our team for feedback, changed schedules and benefits, added profit-sharing opportunities, and offered personal banking and investment services. We also built a culture around clear expectations, accountability, professional development, and shared purpose. Compensation was one part of a much larger experience.
More than one responsible compensation model can work. Salary-only can fail under weak leadership and poor culture, and production-based compensation can work well in a strong, ethical practice.
When I say in lectures, "There's no right or wrong way, only yours and mine," I do not mean every choice is equally sound. Evidence, fairness, ethics, and patient care still set boundaries. I mean more than one responsible path may exist, and a method only makes sense within the leadership, culture, people, and total package surrounding it. A pay formula cannot do a leader's job. It takes more than a paycheck to motivate employees.
Test the Idea Before You Change the Practice
Because I teach and advise veterinary professionals, I worry that a nuanced lesson can easily be mistaken for a universal rule. I may explain why salary worked in our practice, only for someone to leave believing, "Ernie says salary is the best system. That's what I'll do." It isn't that simple.
My experience is one example to consider, not an absolute truth. The same applies to ideas from a conference speaker, consultant, industry leader, colleague, or this newsletter. A sound lesson can still be a poor fit for your circumstances.
At your next team huddle or leadership meeting, choose one important decision or proposed change your practice is considering. Before changing an entire system, test the thinking behind it. Ask three questions:
- What problem are we trying to solve, and what evidence tells us that it is the real problem?
- What made this approach work elsewhere, and which of those conditions exist in our practice?
- What is the smallest useful way to test one key assumption over the next 30 days? Who will lead it? What results will shape our next step?
Ask the people closest to the work what they are seeing. Put the 30-day review date on the calendar before you begin, and be willing to adjust more than just the proposed method. The purpose is to learn whether the idea addresses the real problem and improves the work, the medicine, and the experience of the people involved. At the review, decide whether to move forward, adapt the idea, or set it aside.
Expert teaching remains valuable even when your final answer differs from the teacher's. My father's misses taught me. So did his wins. Veterinary and business leaders helped me even when their recommendations led me toward a different answer. Learning from many is the starting point. Leadership is shaping those lessons into a path you can explain, test, and own.
Dr. Ernie Ward
Chief Veterinary Officer, VerticalVet
PS - Questions or suggestions for "The Altitude"? Email me at
Suggested Reading
These three books explore how leaders can learn broadly, challenge attractive assumptions, and turn outside evidence into decisions that work in their own circumstances.
- Range: Why Generalists Triumph in a Specialized World by David Epstein
Epstein, the genius behind Inside the Box: How Constraints Make Us Better, explains how people working in complex, unpredictable fields often benefit from broad experience, experimentation, and ideas drawn from different disciplines. It's a useful reminder that your best veterinary strategy may come from connecting lessons that other people keep separate. - Think Again: The Power of Knowing What You Don't Know by Adam Grant
Another banger from the incomparable Adam Grant. Here, Grant examines the ability to reconsider assumptions, listen to conflicting evidence, and revise a belief without losing confidence or direction. It's especially valuable for leaders who want to learn from experts without turning yesterday's success into tomorrow's rigid rule. A must-read for any leader. - Hard Facts, Dangerous Half-Truths, and Total Nonsense by Jeffrey Pfeffer and Robert I. Sutton
This is a book I look to for serious advice on specific issues rather than a cover-to-cover read. Using case studies and real-world examples, Pfeffer and Sutton challenge the habit of blindly copying celebrated "best practices." They make a practical case for combining credible evidence with local realities and disciplined testing rather than relying on management fashion, heroic success stories, or intuition alone. It lives on my bookshelf within easy reach.
Quote I’m Contemplating
"Where is the wisdom we have lost in knowledge?
Where is the knowledge we have lost in information?"
T. S. Eliot (1888-1965), from Choruses from The Rock (1934)
Eliot's questions may be the best summary of this month's column. We now have access to more business information than any generation of veterinary leaders before us. We can collect articles, podcasts, conference notes, dashboards, expert opinions, and AI-generated answers faster than we can possibly apply them. Yet the hardest part remains unchanged: deciding what any of that information means for the situation in front of us.
Information told me that free vaccines and discounting had worked for other veterinary clinics. Knowledge helped me understand why those tactics may have succeeded. Wisdom required deciding whether the same assumptions fit the practice I wanted to build.
That final, and most important step is synthesis. It requires curiosity without gullibility, confidence without rigidity, and enough humility to recognize that two thoughtful leaders can study the same evidence and reach different conclusions. Neither has to be foolish or dishonest. They may simply be solving different problems.
The goal isn't to distrust expertise or seek less information. It's to resist mistaking the accumulation of information for judgment. Keep gathering ideas. Keep learning from other people's wins and losses. Then do the work Eliot's questions demand: turn what you know into a decision that is wise for your practice.
The Altitude Monthly
September 2026 Edition
By Dr. Ernie Ward, Chief Veterinary Officer, VerticalVet
Insights on Pets, People, and the Profession to Elevate Your Veterinary Team