The actual problem is that the unmonetizable value gets tossed out by PE. E.g. customer service will take a massive dive because everyone working for the clinic or whatever else will be time-pressured out of good service.

Generally the problem with treating everything via pure financial models is that some things are valuable but hard to measure financially and those are inevitably destroyed by PE and other entropy-maximizers.

You're shifting goalposts. Your first comment was about how small businesses could just refuse to sell, then a commenter described the (very real) consequences of that decision: a person has to work harder, for less money, to compete with entities that can outspend them by a few factors. Now you're saying that's more efficient overall which is a completely different point.

And, that's true, it is more efficient. But those veternarians, despite now having their weekends off, are paid barely market rate for their skills (if that) and more importantly, no longer running their business: A PE firm is. That means they have zero recourse if the PE firm starts doing PE firm shit: keeping bare minimum stock at their clinic of every last consumable, to avoid taxation; keeping bare minimum staff at all times to avoid paying workers; abusing staff and causing high turnover; basically every stupid ass "why would they do that" type decision you've heard of a large business making in the last 30 years, PE's LOVE those decisions.

And that's not even going into the fact that the profits of that business are no longer going to the community in which it operates, they're going to far away shareholders.

More efficient for the mega-vet, sure. Once you've consumed all the competition, there's no need to compete on price anymore. Prices can go up quite a bit before it becomes economical for a new entrant to take a risk in the market. Except maybe another mega-vet.

See what Walmart did to communities and small business. Efficiency is not all roses.

Think of Comcast but for puppies' health