For veterinarians considering practice ownership, one question often arises before any discussion about financing, location, or equipment:
Should I start a practice from scratch or purchase an existing one?
We’ve seen veterinarians succeed through both avenues. Some have built thriving hospitals from the ground up. Others have purchased established practices and transformed them into something entirely their own.
Both paths can work.
But after decades of helping veterinarians navigate ownership transitions, we know the journey often looks very different from what people imagine when they’re sketching floor plans on a napkin or driving past a vacant building with “future clinic” dreams.
The Lending Process
When financing the purchase of an established practice, a lender has something tangible to evaluate. There are financial statements, tax returns, production reports, and years of operating history. The practice has already answered one of the lender’s most important questions:
Will clients actually show up?
A startup requires a different conversation. Instead of looking backward, lenders are looking forward. They are evaluating projections, demographics, market demand, and, perhaps most importantly, the veterinarian behind the plan. In many respects, the bank is investing as much in the owner as it is in the future practice.
Beginning at Zero
A startup offers something many veterinarians find appealing: a blank slate.
You choose the location, design the facility, create the culture, and determine how medicine will be practiced from day one. For entrepreneurs with a strong vision, that level of control can be incredibly rewarding.
Of course, someone still has to choose the software, interview the technician candidates, review the marketing proposals, troubleshoot the internet outage, and figure out why the contractor’s timeline suddenly doubled.
In a startup, that “someone” is often you.
An acquisition brings different challenges, but it also provides momentum. The practice is already serving clients, generating revenue, and operating as a business. Some systems may need improvement. Some processes may leave you scratching your head. But you’re not beginning at zero.
Time to Profitability
A startup begins with an empty appointment book.
Every client relationship must be earned. Every positive review must be generated. Every referral must come from somewhere. Even in attractive markets with careful planning, building those relationships takes time. The new owner must financially weather that ramp-up period.
An acquisition offers a different starting point.
The clients are already there. The reminder cards are already going out. The practice has already spent years building trust within its community. Revenue doesn’t need to be invented; it needs to be maintained and, ideally, improved.
This is one reason many first-time owners are surprised by the appeal of an acquisition. What initially feels less exciting than building something new often begins to look more attractive once they realize the cash flow comes with the transaction.
Cultivating Your Team
Ask almost any practice owner what keeps them up at night, and staffing will eventually enter the conversation.
Startup owners enjoy the opportunity to build a team from the ground up. They can hire individuals who align with their culture, philosophy, and vision for the future.
The challenge is finding those individuals.
Veterinarians across North America know that recruiting qualified doctors, technicians, and support staff is rarely as simple as posting a job description and waiting for applications to arrive. There are practice owners right now that have been trying to hire key talent for years.
With an acquisition, employees are usually part of what you’re purchasing. They know the clients. They know the workflows. They know where the extra printer paper is hidden.
While leadership transitions always require care and communication, many buyers find tremendous value in having experienced team members help carry the practice forward from day one.
Embracing the Uncertainty
The startup-versus-acquisition debate isn’t really about which path is “best.” It’s about deciding where you’d prefer the uncertainty to live.
With a startup, much of the uncertainty surrounds building the business. With an acquisition, more of the focus shifts toward operating and improving an existing one.
Neither path guarantees success.
But after years of watching ownership transitions unfold, we’ve found that veterinarians are often surprised by how much they value existing clients, existing staff, existing cash flow, and existing proof that a business works. Vision is important. So is momentum.
The key is understanding which ingredients matter most to you before you begin the journey.
Ready to compare your options? If you’re considering practice ownership, don’t make the decision based solely on the excitement of opening your own doors. Look at the numbers, the risks, the timeline, and the long-term implications of each path.
In our upcoming Hour with the Experts webinar, “Build It or Buy It? The Realities of Veterinary Practice Ownership,” experts from Simmons and Bank of America will take a deeper dive into the practical realities of both options—including financing, start-up costs, existing goodwill, profitability, risk, and long-term value.
To join the live webinar September 15 at 7 p.m., register here. Can’t make the event? Register anyway, and we’ll send you the recording.
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