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, troubleshooting 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 evolved dramatically. What was once considered an administrative position has become one of the most influential leadership roles inside a veterinary hospital.
Yet according to our 2026 Veterinary Practice Manager Report, many Practice Managers remain far more involved in executing strategy than creating it. They oversee critical operational functions every day but are often left out of the conversations that determine where the practice is headed.
That disconnect 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’re responsible for connecting nearly every moving part of the practice.
The 2026 report found that Practice Managers spend much of their time on:
- Inventory and vendor management
- Supervising team performance
- Working alongside the clinical team
- Financial oversight
- Facility management
- Billing and invoicing
- Client concerns
- Scheduling and workflow coordination
In many hospitals, they’re also responsible for onboarding, training, recruiting, payroll coordination, policy implementation, and helping maintain practice culture.
That’s an extraordinary amount of responsibility.
But responsibility alone doesn’t create leadership.
Leadership requires context.
Operational Responsibility Is Not the Same as Strategic Authority
One of the most revealing findings in this year’s report is the difference between operational responsibility and strategic authority.
Nearly half of Practice Managers reported spending significant time on financial oversight, and many listed it among their primary responsibilities.
By comparison, only about one in five reported spending significant time on strategic planning.
Think about what that means.
Practice Managers are expected to:
- Manage staffing
- Control inventory
- Improve efficiency
- Support financial performance
- Solve workflow issues
- Maintain culture
But many aren’t consistently invited into discussions about:
- Annual goals
- Growth initiatives
- Capital investments
- Budget planning
- Long-term hiring strategies
- Marketing priorities
It’s a little like asking someone to captain a ship without showing them the map.
Why Strategic Planning Matters
Some owners hesitate to involve Practice Managers in strategic planning because they believe strategy should remain an ownership responsibility.
In one sense, that’s true.
Owners should absolutely determine the long-term vision of the practice.
But developing the vision and implementing the vision are two very different things.
Practice Managers are the people translating goals into daily execution.
When they’re involved earlier in the planning process, they bring valuable operational insight that owners simply can’t see from a higher level.
They know:
- Which systems are creating bottlenecks.
- Which employees need additional support.
- Which vendors consistently create problems.
- Which client complaints appear repeatedly.
- Which processes waste the most time.
That’s information every strategic discussion should include.
Better Strategy Starts on the Hospital Floor
The people closest to daily operations often identify opportunities before anyone else.
For example:
An owner may decide the practice needs to increase appointment capacity.
A Practice Manager may immediately recognize that the current technician schedule can’t support additional appointments without creating burnout.
An owner may decide it’s time to expand services.
A Practice Manager may know the hospital lacks the equipment, training, or staffing needed to deliver those services successfully.
Neither perspective is wrong.
They’re simply incomplete without the other.
The strongest strategies combine executive vision with operational reality.
Context Creates Better Decision Making
One of the strongest themes throughout the Practice Manager Report is the importance of context.
Practice Managers don’t necessarily need final authority over every strategic decision.
They do need enough information to understand why decisions are being made.
When leaders understand the financial goals behind staffing decisions…
They coach employees differently.
When they understand revenue targets…
They prioritize workflow improvements differently.
When they understand long-term growth plans…
They make purchasing and scheduling decisions differently.
Context changes execution.
Leadership Is Built Through Participation
Many organizations unintentionally treat strategic planning like a once-a-year event.
Leadership, however, happens every day.
Practice Managers become stronger leaders when they’re invited into conversations such as:
- Annual planning meetings
- Budget reviews
- Quarterly business updates
- Marketing discussions
- Expansion planning
- Capital purchase decisions
- Performance reviews of major initiatives
Participation builds ownership.
Ownership builds accountability.
Accountability builds stronger hospitals.
Smaller Practices Need This Even More
The survey leaned heavily toward practices generating less than $2 million in annual revenue, many of them single-doctor hospitals.
In smaller practices, there often isn’t another management layer.
The Practice Manager is the leadership team.
If they aren’t involved in strategic planning, there’s frequently no one bridging the gap between ownership and execution.
That can lead to:
- Miscommunication
- Slower implementation
- Employee frustration
- Inconsistent priorities
- Missed opportunities
The smaller the practice, the more valuable strategic alignment becomes.
Practical Ways to Include Practice Managers
Including Practice Managers in strategy doesn’t require a complete leadership overhaul.
Start with simple habits.
Share annual priorities
Make sure your Practice Manager understands the practice’s biggest objectives before the year begins.
Review financial performance together
You don’t have to share every financial detail.
But reviewing key performance indicators creates stronger business understanding.
Ask operational questions
Before launching major initiatives, ask:
“What challenges do you see?”
“What resources will we need?”
“What could prevent this from succeeding?”
Those conversations often identify issues early.
Create regular strategy meetings
Monthly leadership meetings focused on the future rather than today’s emergencies can dramatically improve alignment.
The Future of Veterinary Leadership
Veterinary medicine continues to evolve.
Practices are becoming larger.
Client expectations are increasing.
Margins are tighter.
Technology is changing rapidly.
Every one of those changes increases the value of strong operational leadership.
Practice Managers already influence nearly every part of the hospital.
The next step isn’t giving them more responsibility.
It’s giving them greater visibility.
Hospitals that successfully connect strategic planning with operational leadership won’t simply become more efficient.
They’ll become more adaptable.
More resilient.
And better prepared for whatever comes next.
Download the 2026 Veterinary Practice Manager Report
Strategic planning is only one of the leadership opportunities explored in our 2026 Veterinary Practice Manager Report.
Inside, you’ll discover research from more than 450 veterinary professionals covering budgeting, accountability, benefits, recruiting, leadership alignment, owner relationships, and practical recommendations to help your hospital grow.
Download your free copy of the 2026 Veterinary Practice Manager Report and learn how stronger leadership systems create stronger veterinary hospitals.