Bigger, Better & Already Outdated? What If the Future of Veterinary Medicine Isn't a Building? (#681)

Is the New Veterinary Medical Teaching Hospital being built for yesterday's veterinary medicine?

UC Davis is planning an extraordinary new veterinary hospital.

The proposed Small Animal Hospital will be large, technologically sophisticated and expensive.

Current university plans put the project cost at $327 million, with completion anticipated in 2029. It is intended to increase annual patient capacity dramatically while expanding specialty medicine, emergency and critical care, advanced treatment, clinical education and research.

It will undoubtedly be impressive.

It may become one of the most advanced veterinary hospitals in the world.

But there is another question worth asking.

Is building a bigger and better version of the veterinary teaching hospital an investment in the future?

Or is it an extraordinarily expensive refinement of a model whose role is already changing?

That is not an argument against UC Davis.

Nor is it an argument against veterinary teaching hospitals.

It is a question about strategy.

When hundreds of millions of dollars are committed to infrastructure expected to serve the profession for perhaps half a century, we should ask not simply what veterinary medicine needs today.

We should ask:

What will veterinary medicine look like in 2040, 2050 and 2060?

And are we building for that profession?

The Writing On The Wall

Several changes are occurring simultaneously in veterinary medicine:

• Clinical education is becoming increasingly distributed.

• Specialty medicine is expanding outside universities.

• Large private and corporate specialty hospitals possess technologies once found almost exclusively in academic medical centers.

• Telemedicine and remote consultation are changing access to expertise.

• Artificial intelligence is beginning to alter diagnostic reasoning, imaging, medical records, and clinical decision support.

• Veterinary practices are consolidating.

• The economics of advanced veterinary care are becoming increasingly difficult for many animal owners.

• Universities themselves face shortages of clinical faculty.

• Students face substantial educational costs.

• The traditional assumption that the veterinary teaching hospital must sit physically at the center of veterinary education is being challenged.

None of these developments means the teaching hospital is disappearing.

But together they suggest something important:

The future veterinary ecosystem may be increasingly distributed rather than centralized.

If that is true, constructing ever larger centralized hospitals deserves scrutiny.

The Hospital Was Once the Center of Everything

Historically, the veterinary teaching hospital performed several functions simultaneously:

• It educated veterinary students.

• It trained interns and residents.

• It provided specialty referral medicine.

• It generated clinical research.

• It gave faculty access to patients.

• It housed advanced diagnostic equipment.

• It connected the university to the veterinary profession.

There were compelling reasons to bring all these activities together

• Specialists were concentrated in universities.

• Advanced imaging was concentrated in universities.

• Clinical researchers were concentrated in universities.

• Specialty caseloads were concentrated in universities.

• Students therefore needed to be there too.

But veterinary medicine has changed.

The question is whether the architecture of veterinary education has changed with it.

Specialty Medicine Has Left the Campus

One of the most important developments of the past several decades has been the enormous growth of private specialty practice.

Neurology, oncology, cardiology, surgery, internal medicine, ophthalmology, dermatology, emergency and critical care, advanced imaging and other specialties are now widely available outside universities.

Many private specialty hospitals possess MRI, CT, sophisticated operating rooms, intensive-care units and advanced therapeutic technologies.

• Some have large specialist staffs.

• Some have substantial clinical caseloads.

• Some train residents.

• Some participate in clinical research.

• Some are part of enormous veterinary organizations with resources that rival those of universities.

  
  

The academic veterinary hospital no longer has a monopoly on sophisticated veterinary medicine.

That changes the strategic question.

Instead of asking:

How do we build an even larger academic hospital?

perhaps universities should also ask:

What can a university veterinary medical center provide that the rapidly evolving private specialty sector cannot?

That answer should determine what we build.

The Distributed University

Imagine another model.

Instead of concentrating nearly everything within one enormous physical hospital, the veterinary school becomes the hub of a network:

• Students rotate through carefully selected general practices.

• Specialty training occurs partly within university facilities and partly in affiliated specialty hospitals.

• Community veterinarians become genuine educational partners.

• Faculty expertise travels electronically as well as physically.

• Clinical trials recruit patients across networks rather than relying predominantly on animals presented to one hospital.

• Specialists collaborate across institutions.

• Advanced imaging can be interpreted remotely.

• Pathology already demonstrates how successfully expertise can be separated geographically from the patient.

• Teleconsultation can connect practitioners with university specialists.

• Artificial intelligence may further weaken the relationship between expertise and physical location.

  
  

In such a model, the university remains intellectually central without necessarily being physically central.

That distinction may become increasingly important.

What Does a $327 Million Hospital Commit You To?

Buildings are not simply capital investments.

They create institutional obligations.

A $327 million hospital must be staffed, maintained, equipped, updated, heated, cooled, cleaned, administered, and filled with patients.

• Highly sophisticated equipment becomes obsolete and must be replaced.

• Specialists must be recruited and retained.

• Technicians and nurses must be employed.

• Clinical services must generate sufficient activity to justify the infrastructure.

A major hospital therefore creates a gravitational pull.

Once built, the institution needs the hospital to remain busy.

That can subtly influence educational and clinical priorities.

The university begins with the question:

What hospital do we need to accomplish our mission?

But decades later the question can become:

What must we do to sustain the hospital we built?

Those are not necessarily the same thing.

The Economics of Advanced Veterinary Medicine

There is another issue we should not ignore.

Who will be able to afford the medicine provided in the veterinary hospital of the future?

Veterinary medicine can now do extraordinary things.

Advanced imaging, radiation therapy, complex oncology.

Dialysis, minimally invasive procedures, sophisticated orthopedic and neurological surgery, intensive care, and genomic diagnostics.

The technological frontier continues to advance.

But every technological advance creates another question:

Who pays?

Veterinary medicine differs fundamentally from human medicine in the United States.

For most patients, there is no Medicare. No Medicaid. No universal third-party payment system. Pet insurance remains far from universal.

Ultimately, much of the cost reaches the animal owner.

As academic veterinary hospitals become more technologically sophisticated, the gap between what medicine can do and what many clients can afford may widen.

A magnificent hospital filled with technologies inaccessible to much of the population creates an uncomfortable tension for a public university.

The future of veterinary medicine may require not simply more advanced care.

It may require more accessible care.

Those are not necessarily the same investment.

What Else Could $327 Million Build?

This is where opportunity cost becomes important.

Every major capital investment represents choices about what is not being funded instead.

Imagine even a fraction of several hundred million dollars invested in:

• A statewide or national network of clinical educational partners.

• Community-practice teaching faculty.

• Student housing during distributed rotations.

• Simulation centers.

• Mobile clinical units.

• Rural veterinary programs.

• Shelter medicine.

• Telemedicine infrastructure.

• Clinical faculty positions.

• Residency training.

• Research personnel.

• Data systems linking thousands of clinical cases.

• Subsidized care for underserved animal owners.

• Scholarships.

• Artificial-intelligence infrastructure.

• Programs supporting new graduates during their transition into practice.

The comparison is not entirely fair because philanthropic gifts and capital funding are often restricted to particular purposes.

Nevertheless, the strategic question remains legitimate:

If we were designing veterinary education from scratch in 2026, would we place several hundred million dollars into one enormous hospital?

Or would we build a network?

The Argument for the Hospital Is Still Powerful

There is, however, a strong counterargument.

Some things genuinely benefit from concentration:

• Complex multidisciplinary medicine is one.

• A patient requiring neurologists, surgeons, anesthesiologists, radiologists, pathologists and criticalists benefits from having them in the same institution.

• Residency training requires specialist supervision and sufficient numbers of complex cases.

• Certain clinical trials require tightly controlled infrastructure.

• Advanced procedures require expensive equipment and specialized teams.

• Translational research benefits from close relationships among clinicians and scientists.

UC Davis explicitly describes the new hospital as supporting not only greater patient capacity but enhanced teaching, collaboration and discovery.

And the broader Veterinary Medical Complex is intended to support research, specialty training and expansion of the veterinary workforce.

UC Davis announced in 2025 that its expansion would include a veterinary education pavilion, primary care hospital, equine hospital, veterinary cancer center, spay-neuter clinic and raptor center.

These are serious academic missions.

The question is therefore not whether a university veterinary medical center has value.

Clearly it does.

The question is how much of the future veterinary enterprise needs to be physically concentrated within it.

Perhaps the Hospital Should Become Smaller in Concept, Not Necessarily in Size

The veterinary teaching hospital of the future may need to abandon the ambition to be everything.

It need not reproduce general practice.

Community veterinarians already do that.

It need not monopolize specialty medicine.

That world has already disappeared.

Instead, the academic veterinary medical center might concentrate on what universities uniquely do well:

• The most complex multidisciplinary cases,

• Training specialists and clinician-scientists,

• Clinical trials,

• Translational research,

• Development of new technologies,

• Comparative medicine,

• Advanced diagnostic and therapeutic innovation,

• Creating knowledge that eventually moves outward into the profession.

  
  

The hospital becomes the specialized nucleus of a much larger distributed system.

That is very different from assuming the hospital itself is the system.

Primary Care Raises an Interesting Question

UC Davis is not moving entirely toward tertiary medicine.

Its broader Veterinary Medical Complex plans also include a new Primary Care Hospital and Veterinary Education Pavilion, a project that entered the design-build phase in 2026.

That is educationally interesting.

Universities recognize that students need exposure to primary care.

But if one of the strongest arguments for distributive education is that authentic primary care already exists throughout the community, why recreate it inside the university?

Perhaps there are good reasons.

A university-controlled primary-care environment allows standardized teaching, faculty supervision and reliable assessment.

But again, we should ask:

Are we building facilities because they are the best educational solution.

Or because universities remain most comfortable educating students within facilities they control?

Control and educational quality are not necessarily synonymous.

The Risk of Building for Yesterday's Definition of Excellence

Universities understandably think in terms of excellence.

• The finest faculty.

• The most advanced equipment.

• The most sophisticated hospital.

• The largest caseload.

• The newest technology.

But the definition of institutional excellence may be changing.

Perhaps the best veterinary school of 2050 will not be the one with the largest hospital.

Perhaps it will be the one with:

• The best network.

• The strongest partnerships with community practitioners.

• The largest distributed clinical database.

• The most effective teleconsultation system.

• The best integration of artificial intelligence.

• The most geographically diverse clinical education.

• The strongest connections among animal, human and environmental health.

• The most successful transition-to-practice programs.

• The greatest access to veterinary care.

And perhaps a highly sophisticated academic medical center at the hub - but not dominating the entire system.

That would represent a very different measure of prestige.

Buildings Are Visible. Networks Are Not.

There may also be a psychological reason universities favor buildings:

• Buildings are tangible.

• Donors can walk through them.

• Administrators can open them.

• Architects can render them.

• Names can be placed on them.

• Photographs can appear in fundraising campaigns.

• Networks are harder to see.

A distributed educational partnership involving 200 veterinary practices may transform veterinary education without producing a dramatic architectural photograph:

• A mentoring network may profoundly affect hundreds of graduates without having a lobby.

• A clinical data network may change veterinary medicine while existing largely on servers.

• A scholarship fund has no operating room.

• A faculty position has no façade.

Universities should be careful not to confuse what is visible with what is transformative.

The Fifty-Year Question

UC Davis' current Veterinary Medical Teaching Hospital opened in 1970. When plans for its replacement and expansion were discussed decades later, the university noted how dramatically veterinary medicine had changed since that facility was conceived.

That history should give us pause.

A hospital completed around 2030 may still be operating in 2070.

Try imagining veterinary medicine then:

• Artificial intelligence may interpret much routine diagnostic information.

• Remote monitoring may keep animals away from hospitals until intervention is necessary.

• Genomic medicine may identify disease risk before clinical disease develops.

• Some treatments may occur at home.

• Specialists may consult across continents.

• Robotic and image-guided procedures may alter surgery.

• Clinical trials may operate through enormous distributed patient networks.

• The boundaries between veterinary medicine, human medicine and environmental health may be substantially different.

• Veterinary education itself may be far less geographically centralized.

We cannot predict that future.

Which is precisely the point.

The more uncertain the future, the more cautious we should be about locking enormous resources into infrastructure designed around today's assumptions.

Is UC Davis Ignoring the Writing on the Wall?

Perhaps.

But that conclusion would be too easy.

UC Davis can make a strong case for a major academic veterinary medical center. Its enormous caseload, specialty programs, research enterprise, residency training and comparative medical mission distinguish it from an ordinary veterinary hospital.

The new hospital could become an extraordinary engine for discovery and advanced veterinary medicine.

The danger lies elsewhere.

The danger is assuming that because the great veterinary school of the twentieth century was built around a great teaching hospital, the great veterinary school of the twenty-first century must simply build a greater one.

That assumption deserves examination.

The future may belong not to the institution with the biggest building, but to the institution that most effectively connects knowledge wherever it resides:

• University specialists.

• Community practitioners.

• Private specialty hospitals.

• Researchers.

• Students.

• Animal owners.

• Public-health agencies.

• Data.

• Technology.

• And patients.

The veterinary teaching hospital should remain part of that ecosystem.

Perhaps an indispensable part.

But it may no longer need to be its center of gravity.

Build the Future, Not Just the Hospital

The question therefore should not be:

Does UC Davis need a new veterinary hospital?

Its aging facilities, caseload and academic programs provide substantial reasons for modernization.

The more important question is:

What proportion of UC Davis' vision for the future of veterinary medicine should be embodied in a building?

A $327 million hospital is a powerful statement about what an institution believes the future will require.

Before the concrete is poured and the operating rooms filled with technology, every veterinary school contemplating such investments should ask a deceptively simple question:

If we were inventing veterinary medicine today, would we build it this way?

Perhaps the answer is yes.

Perhaps the answer is partly.

But we should at least be willing to ask.

Because the greatest danger facing an institution with a distinguished past is not that it will fail to build something impressive.

It is that it will build an extraordinarily impressive solution to yesterday's problem.

Glossary of Terms

Academic Veterinary Medical Center

A university-based clinical enterprise combining veterinary patient care with teaching, specialist training, research and the development of new knowledge. It has traditionally occupied a central role in veterinary education.

Veterinary Medical Teaching Hospital (VMTH)

A veterinary hospital operated by a university in which patient care is integrated with the education of veterinary students, interns and residents and, frequently, with clinical research.

Veterinary Medical Complex (VMC)

The broader collection of clinical, educational and research facilities being developed at UC Davis. It encompasses more than a single veterinary teaching hospital.

Small Animal Hospital

The major new UC Davis facility intended for the diagnosis and treatment of companion animals and the education of veterinary students and specialists. Current plans place its projected cost at approximately $327 million.

Primary Care

First-contact veterinary care, including preventive medicine, routine diagnosis and treatment and management of common diseases. Most primary care occurs in community veterinary practices rather than university hospitals.

Specialty Medicine

Advanced veterinary care provided by veterinarians with additional postgraduate training and specialist qualifications in disciplines such as surgery, neurology, oncology, cardiology, internal medicine, ophthalmology, radiology and emergency and critical care.

Tertiary Care

Highly specialized referral care for animals with complex diseases or conditions that generally cannot be managed within ordinary primary-care practice.

Referral Hospital

A hospital to which general practitioners send patients requiring specialist expertise, advanced diagnostics or complex treatment.

Distributed Clinical Education

A model in which veterinary students receive substantial portions of their clinical education at multiple external sites - such as community practices, specialty hospitals, shelters and other partner organizations - rather than predominantly within a university-owned teaching hospital.

Distributed University

The broader concept proposed in this essay: a university that remains the intellectual and educational hub of a network while teaching, clinical care and research occur across many geographically separate partner institutions.

Hub-and-Network Model

A system in which the university provides a central academic nucleus while community practices, specialty hospitals and other organizations form an interconnected clinical and educational network.

Telemedicine / Teleconsultation

The use of communications technology to provide clinical expertise or specialist consultation without requiring the specialist, veterinarian and patient to be physically present in the same location.

Artificial Intelligence (AI)

Computer systems capable of performing tasks associated with human reasoning or pattern recognition. In veterinary medicine, potential applications include diagnostic imaging, medical records, clinical decision support, data analysis and research.

Clinical Caseload

The number and variety of patients presented to a hospital or clinical service. Adequate caseload is particularly important for teaching students, training specialists and supporting clinical research.

Opportunity Cost

What must be forgone when resources are committed to one purpose rather than another. The essay asks what alternative educational, clinical and research initiatives might be possible if resources were not concentrated so heavily in physical infrastructure.

Capital Investment

Money committed to long-lived physical assets such as buildings and major equipment. A hospital is a capital investment, but it also creates substantial continuing operating costs.

Institutional Commitment

The long-term obligations created by a major decision. Once a large hospital is built, it must be staffed, maintained, equipped, modernized and supplied with sufficient patients for decades.

Gravitational Pull of the Hospital

A metaphor used in the essay for the way a major physical investment can begin to influence institutional priorities. Once a large hospital exists, maintaining its staffing, caseload and financial sustainability inevitably becomes important to the university.

Access to Veterinary Care

The ability of animal owners to obtain appropriate veterinary services. Access may be affected by cost, geography, availability of veterinarians and specialists, transportation and other barriers.

Centralized versus Distributed Medicine

The contrast between concentrating expertise, technology, patients and education within one major institution and distributing those activities across an interconnected network.

The Fifty-Year Question

The essay's challenge to evaluate a major building not simply against today's veterinary profession but against the profession that may exist throughout the building's working life - potentially to 2070 and beyond.

Additional Reading

UC Davis Receives $120M Gift, Largest Ever to Veterinary Medicine. https://www.ucdavis.edu/news/uc-davis-receives-120m-gift-largest-ever-veterinary-medicine

Veterinary Medical Center | Small Animal Hospital. https://dcm.ucdavis.edu/projects/vet-med-small-animal-hospital

UC Davis receives $75M historic gift in support of veterinary medicine. https://giving.ucdavis.edu/impacts-giving/uc-davis-receives-75m-historic-gift-support-veterinary-medicine

Expanding the Veterinary Medical Complex: a New Small Animal Hospital. https://www.vetmed.ucdavis.edu/giving/giving-stories/new-small-animal-hospital

Expanding the Veterinary Medical Complex: An Update. https://www.vetmed.ucdavis.edu/giving-articles/expanding-veterinary-medical-complex-update

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