Big hospital, little hospital: The pros and cons of each (for you and your pets)

Patty Khuly, DVM
Updated: September 14, 2010
Published: June 17, 2009
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Does your pet frequent a large veterinary hospital or a small one? Does your experience at either sometimes make you wonder whether you’d be better off with the alternate version? 

After all, it’s like choosing a college or university. The smaller schools have clear advantages over the bigger ones...and vice versa. But do you know what they are when it comes to veterinary care? 

First, a little history: 

We used to call them all “clinics.” It once seemed pretentious to call them anything else, considering the “single-man” smallness of the average place.  But then came the eighties, when everything got bigger overnight, it seemed:

Veterinary schools got more sophisticated in their teaching, small hospitals made room for specialists, grads sought out places with softer, more flexible hours, service offerings expanded, medical equipment got more expensive, drugs and products pricier to haul, and all other economies of scale prompted the move towards big facilities and hospital chains.

But some stayed small, either because of necessity (zoning issues, for example) or because many single or double-practitioner practices preferred to pay more for the right to remain nimble and independent. Why change models when you can still offer most of the services the big guys do in your smaller, more manageable place?

So now we call all veterinary facilities “practices” and “hospitals.” The wide range of services even the smallest veterinary establishment can offer grants all but the lowliest, vaccine-only outlets the right to such a lofty designation. 

Still, it’s clear there’s a big difference between the big places and the small. One size definitely does not fit all. Here’s a rundown of the major pros and cons for your consideration:

Large Veterinary Hospitals

These are the places with an average of at least five full-time veterinarians in tow. They may have more than one office to help meet your numerous needs for multiple pet-related services, or they’ll concentrate it all in one mega-facility for your supreme convenience. 

Pro: Convenience

The single biggest wondrous development in the big hospital model comes with the one-stop shopping of it all. Here’s a quick list of what the biggies tend to offer on this front:

  • easy appointments on your schedule (sometimes nighttime and weekends, too)
  • 24-hour emergency care
  • ancillary services like boarding and grooming fast
  • in-house lab testing
  • easy access to specialists (sometimes even in-house)
  • great parking for fast ins-and-outs

Con: Less personal

Yeah, that’s the down-side. You may not be able to see the same doc twice for any given problem. The built-in employee flexibility means that sometimes your favorite vet won’t be there for the follow-up. The receptionist and technician turnover may be intense. It may even feel like a business and not like a place where animal-loving happens. But not always.

Small Veterinary Hospitals

One to three full-time docs is typically the max for your standard “mom and pop” vet hospital. 

Pro: Personal

That’s the best part. The receptionists remember you. The veterinarian will get on the phone to answer your questions. The staff knows your name. And if you’re a great client, you and your pets will truly feel valued. 

Con: Limited 

Though even the tiniest hospitals have X-rays, complete surgical works and  may even be more proactive about referring you to a specialist when necessary, lots of your one-stop shopping isn’t happening: no boarding and grooming, your favorite food won’t be there unless you remember to place an order, if your vet’s out of town you may need to go to another hospital to be served, and you can forget about overnight care. 

But what about price? Wouldn’t it be cheaper to stay with a small practice? 

Hmmm...not so sure about that. After all, lots of big hospitals got that way because they’re more likely to save money on costs. That means that, per animal served, small hospitals have bigger expenses. 

Still, that doesn’t always translate into higher prices. It all depends on the management style of the practice. Nonetheless, on this subject one thing is clear: smaller hospitals tend to offer more personalized payment services. No doubt about that. That’s not to say that large ones can’t (or won’t), but their larger size makes it more likely that policies regarding payment will be more diligently enforced across the board.


So now it’s your turn: What do you prefer?