Practice Managers Are Leading Operations. Are They Included in Strategy?
Walk through almost any veterinary hospital, and you’ll quickly find the person who keeps everything moving.
They’re coordinating schedules before the first appointments begin. They’re answering questions from technicians, following up with vendors, fixing inventory shortages, resolving client concerns, approving invoices, coaching employees, and making sure the hospital doesn’t miss a beat.
That person is almost always the Practice Manager.
Over the past decade, the Practice Manager role has changed a lot. What was once an office job has become one of the most important leadership roles inside a veterinary hospital.
Yet according to our 2026 Veterinary Practice Manager Report, many Practice Managers are still more involved in carrying out strategy than creating it. They run key day-to-day functions but are often left out of the conversations that decide where the practice is headed.
That gap isn’t just frustrating.
It’s one of the biggest missed opportunities in veterinary leadership today.
The Practice Manager Role Has Changed
Today’s Practice Managers don’t simply manage the office.
They connect nearly every moving part of the practice.
The 2026 report found that Practice Managers spend much of their time on:
- Inventory and vendor management
- Team performance
- Working with the clinical team
- Finances
- Facility upkeep
- Billing and invoicing
- Client concerns
- Scheduling and workflow
In many hospitals, they also handle onboarding, training, hiring, payroll, policies, and practice culture.
That’s a lot of responsibility.
But responsibility alone doesn’t make someone a leader.
Leadership needs context.
Running Day-to-Day Isn’t the Same as Setting Strategy
One of the clearest findings in this year’s report is the gap between day-to-day duties and a real say in strategy.
Nearly half of Practice Managers said they spend a lot of time on finances. Many list it as one of their top responsibilities.
By comparison, only about 1 in 5 spend real time on strategic planning.
Think about what that means.
Practice Managers are expected to:
- Manage staffing
- Control inventory
- Improve efficiency
- Support the bottom line
- Solve workflow problems
- Maintain culture
But many aren’t regularly invited into talks about:
- Annual goals
- Growth plans
- Big purchases
- Budgets
- Long-term hiring
- Marketing priorities
It’s a little like asking someone to steer a ship without showing them the map.
Why Strategic Planning Matters
Some owners hesitate to bring Practice Managers into planning. They think strategy should stay with ownership.
In one sense, that’s true.
Owners should set the long-term vision for the practice.
But building the vision and carrying it out are two different jobs.
Practice Managers turn goals into daily action.
Bring them in early, and they add insight owners can’t see from the top. They know:
- Which systems create bottlenecks
- Which employees need more support
- Which vendors keep causing problems
- Which client complaints keep coming up
- Which processes waste the most time
That’s information every strategy conversation needs.
Better Strategy Starts on the Hospital Floor
The people closest to daily operations often spot opportunities first.
For example:
An owner may decide to book more appointments per day.
A Practice Manager may know right away that the current technician schedule can’t handle it without burning out the team.
An owner may decide it’s time to add new services.
A Practice Manager may know the hospital lacks the equipment, training, or staff to pull it off.
Neither view is wrong.
They’re just incomplete without each other.
The best strategies combine the owner’s vision with the manager’s ground-level view.
Context Leads to Better Decisions
One of the strongest themes in the Practice Manager Report is context.
Practice Managers don’t need the final say on every decision.
But they do need enough information to understand why decisions are made.
When they understand the money behind a staffing call…
They coach employees differently.
When they understand revenue goals…
They prioritize workflow fixes differently.
When they understand long-term growth plans…
They make buying and scheduling decisions differently.
Context changes how work gets done.
Leadership Is Built Through Participation
Many practices treat strategic planning like a once-a-year event.
But leadership happens every day.
Practice Managers grow as leaders when they’re invited into:
- Annual planning meetings
- Budget reviews
- Quarterly updates
- Marketing discussions
- Expansion planning
- Big purchase decisions
- Reviews of major projects
Taking part builds ownership.
Ownership builds accountability.
Accountability builds stronger hospitals.
Smaller Practices Need This Even More
The survey leaned toward practices earning under $2 million a year, many of them single-doctor hospitals.
Smaller practices often don’t have another layer of management.
The Practice Manager is the leadership team.
If they’re left out of planning, there’s often no one bridging the gap between ownership and the day-to-day.
That can lead to:
- Mixed messages
- Slower rollout of changes
- Frustrated staff
- Shifting priorities
- Missed opportunities
The smaller the practice, the more this alignment matters.
Practical Ways to Include Practice Managers
Bringing Practice Managers into strategy doesn’t take a full overhaul.
Start small.
Share annual priorities
Make sure your Practice Manager knows the practice’s biggest goals before the year starts.
Review finances together
You don’t need to share every number.
But reviewing key metrics builds real business understanding.
Ask about operations
Before launching something new, ask:
“What challenges do you see?”
“What will we need?”
“What could stop this from working?”
These questions often catch problems early.
Hold regular strategy meetings
Monthly leadership meetings focused on the future — not today’s fires — go a long way toward better alignment.
The Future of Veterinary Leadership
Veterinary medicine keeps changing.
Practices are getting bigger.
Client expectations are rising.
Margins are tighter.
Technology is moving fast.
Every one of those shifts makes strong operational leadership more valuable.
Practice Managers already touch nearly every part of the hospital.
The next step isn’t giving them more work.
It’s giving them more visibility.
Hospitals that connect strategy with day-to-day leadership won’t just run more efficiently.
They’ll become more adaptable.
More resilient.
Better prepared for whatever comes next.
Download the 2026 Veterinary Practice Manager Report
Strategic planning is just one topic in our 2026 Veterinary Practice Manager Report.
Inside, you’ll find research from more than 450 veterinary professionals covering budgeting, accountability, benefits, hiring, leadership alignment, owner relationships, and practical tips to help your hospital grow.
Download your free copy of the 2026 Veterinary Practice Manager Report and see how stronger leadership systems build stronger veterinary hospitals.