Within my new startup practice and even before that, I’ve noticed a continuing trend. Pet owners are coming in with specialty quotes for non-routine surgeries that are completely unaffordable. Whether it’s an orthopedic procedure, an abdominal explore, a splenectomy, or a large mass removal, many clients are looking for alternative options in the general practice (GP) setting. And frankly, most of them aren’t just looking—they’re hoping someone can help them without draining their savings.
In the practices I’ve worked in and been partnered in, we’ve made it a point to train veterinarians in more advanced procedures. When that happens, we’re able to keep a wide range of surgeries in-house, offer them at more accessible price points, and deliver great outcomes. That doesn’t mean we never refer. Referral is still an essential part of patient care. But the truth is, many pet owners simply can’t afford to go that route. And when that’s the case, we need to be prepared to offer another option. That starts with training and ends with empowerment.
This is where general practice can and should level up.
So, What Does Advanced Care in GP Actually Mean?
For me, it means embracing the procedures that fall into the “routine but not basic” category. Cruciate repairs, luxating patella surgeries, femoral head ostectomies, hemoabdomens, intestinal resections, and large mass removals. These are cases that, when done properly, can lead to excellent outcomes. But they require skill, confidence, mentorship, and repeatable systems.
Of course, not everything belongs in a GP setting. Highly complex fracture repairs, procedures requiring fluoroscopy, unstable patients, or any case where the clinic’s equipment or staffing is stretched too thin should still be referred. That’s not up for debate. This is not about competing with specialists. It is about creating more access for the kinds of cases that general practitioners can and should be equipped to handle, with the right training and infrastructure.
And that’s a key point. We’re not replacing specialists. We’re relieving them. We’re taking the predictable, protocol-driven surgeries off their plates so they can focus on what only they can do. Meanwhile, we improve access and affordability for the majority of pet owners.
Training Has to Come First
We all know those GPs who are willing to try anything. I’m probably one of them. But even for people like me, there has to be structure. This is not about improvising on a live case. It’s about investing in your skills, your team, and your outcomes.
If you want to bring advanced procedures into your hospital, you have to commit to doing it right. That means targeted CE. It means attending wet labs. It means shadowing and learning from those who have already done the work. It means proctored cases, complication tracking, and clearly defined case selection criteria.
And just as important, it means preparing your team. Rehearse roles. Build SOPs. Debrief after complications. Standardize pre-op, post-op, and everything in between. When you do that, you don’t just improve clinical quality. You build confidence. You create momentum. And eventually, those advanced procedures become part of the norm.
The Three Wins
This model creates wins across the board.
For pet owners, it means more affordable care. A TPLO that might cost $10,000 at a specialty center can be done in-house for $4,000, with the right training, tools, and protocols. The result? More dogs walk again. More pets get help. More families get to say yes to treatment instead of walking away.
For the hospital, it drives meaningful revenue. These are high-ticket services with solid contribution margins. And in a startup, where patient flow is still building, they can move the needle fast. That’s exactly what we’ve seen at our new practice. Ortho cases, done right, have helped drive revenue early and consistently.
For the Veterinary team, it’s professional development in action. Learning something new. Gaining confidence. Becoming a leader in the hospital. Teaching others. These are the ingredients of long-term engagement and career growth. When a veterinarian takes ownership of a procedure like TPLO, the whole team rises with them. Technicians, assistants, and even future associates all get better.
Ortho is the Example, But It’s Not the Only One
My journey into TPLO and fracture repair didn’t start with CE alone. I was lucky. My first job after graduation was in a hospital where advanced orthopedic procedures were the norm. I watched, learned, asked questions, and eventually went through CE and mentorship to build the skills myself. That early exposure made all the difference.
Now, we’ve brought those procedures into our startup clinic. And the impact has been massive. Not just on revenue, but on access, trust, and community word of mouth. We’ve become the place where other local GPs send cases they know we can handle. We’re not a referral center. We’re just trained, committed, and careful.
How to Start
Pick one service line. Build your inclusion and exclusion criteria. Invest in training. Run simulations before you run cases. Debrief after every case. Create a pricing structure that reflects your time and skill, but still gives owners a path forward.
You don’t have to do everything all at once. But you do have to start.
Final Thought
Bringing advanced care into general practice isn’t a gimmick. It’s not a way to look flashy or boost production numbers. It’s about serving the people who trust us. It’s about expanding access without sacrificing quality. And it’s about giving Veterinary teams a reason to stay engaged and keep growing.
If done right, this isn’t a risk. It’s the next evolution of general practice. Let’s make it the norm.