Keeping veterinary care affordable for pet owners is vital. The rapid increase in the cost of veterinary care, coupled with falling veterinary visit numbers, is a real problem. Our industry needs to be able to discuss how we will keep care accessible, and work together to create solutions.
I’ve recently observed several presenters and writers sharing their proposals for addressing the rising cost of care with groups of veterinarians. It’s my impression that most of these presenters did not get the positive response from veterinarians in the trenches they were expecting.
I think there are a lot of people out there who have very good ideas for what the future of medicine might look like, but they really struggle to connect with the veterinarians doing the work. For that reason, I wanted to give a few quick reminders for things to remember to anyone who is going to be addressing veterinarians about the rising cost of care. Here goes:
Most veterinary clinics are not-very-profitable small businesses – While it might feel like large groups have bought up the lion’s share of clinics, that’s not true (unless you’re talking about emergency and specialty practices. If you are, make sure to say that). Most of them are still for-profit mom-and-pop shops that don’t have large cash reserves or any sort of a social safety net. They stress about paying their staff a living wage and helping their doctors pay off significant student debt loads.
There is no government agency behind these clinics (or corporate clinics) that will step in if they fail financially or pick up the tab if a pet owner doesn’t pay their bill. Also, the average veterinary practice is somewhere around only 10-14% profitable, so they are not raking in huge amounts of cash from the pet owners they see.
One of the fastest ways to get veterinarians to shut down in an access to care conversation is to give the impression that you think their practice has a good amount of extra money they can tap into, or that there is some altruistic group in the background that is helping clinics financially when needed.
For most veterinary practices, money is tight and costs are rising for them as well as pet owners. Access to care conversations that don’t acknowledge financial pain on the side of practitioners tend to go poorly.
There are huge pressures to conform to organizational protocols – A lot of communications I see about access to care seem to assume that associate veterinarians have more freedom to decide how cases are handled than they actually do. While it used to be more normal for veterinarians to kind of run their own cases however they wanted, corporate practices (and high performing independent practices) have steadily moved towards standardizing approaches to care.
I think there are good reasons for this. First, it’s very hard to leverage your trained support staff if they can’t anticipate what’s going to happen with a case and need to wait for the doctor to tell them what to do. Also, it’s impossible to do any sort of medical quality control if each veterinarian is free-styling every shift and there are no established “standard practices” for doctors to align around.
Is it possible that in some practices these standard protocols are more medically intensive than they might need to be? Are there clinics that have protocols that were put together with one eye squarely on revenue generation? I think we have to assume the answer to both questions is yes, but that doesn’t change the position of the veterinarians working there.
Frequently deviating from the prescribed treatment approaches can have negative consequences if you are a veterinarian. Even if your clinic does not factor in how tightly you adhere to these protocols when assessing your job performance, you still have pressure from the support staff who have been taught that following the clinic standards is the “correct” way to practice medicine, and you sometimes have to justify your choices to your fellow veterinarians who will pick up the case later on and think “The last vet was obviously not doing his job.”
I want to be clear here and emphasize that talking about different ways to approach cases and the value of contextualized care is important and I want to see more of it, not less. I am calling out the pressures of conformity to practice protocols because they are very real, and I have seen speakers and writers imply that individual veterinarians are solely responsible for how their cases get worked up. That is not the case for a large number of doctors, and feeling like you’re being told you morally need to do something that your job doesn’t allow you to do really turns people off.
When talking about access to care, remember that many veterinarians are bound to a playbook they didn’t create. Acting like they don’t have this constraint can be deeply frustrating, and it limits the value of a lot of presentations to those doctors.
Access to care is not a sales pitch hook – Just know that an enormous percentage of messaging about the importance of access to care and how the challenge of rising prices can be addressed seems to end with “and that’s why I’m so excited to tell you about my new product!” I’m not saying you can’t or shouldn’t talk about your solution or company. Just know that access to care is frequently being used as a hook to set up sales pitches, and veterinarians are wary of engaging with anything that’s going to turn into an infomercial.
Beware of “If you really cared…” language – If you ever want to see veterinarians get angry, say something along the lines of “If you guys really cared about the pets, you’d charge less.” This is an insult that has been hurled at vets for generations, and it still stings because of how frustrating it is. Veterinarians, as a group, care A LOT about taking care of patients and most of them have made real sacrifices in their lives to ensure patients get care. They also sweat the bills and feel guilty that they aren’t paying their support staff better.
I heard one access to care advocate position himself as “the voice of the pets” while lecturing veterinarians on how they should change the practice act, charge less money, and refer work away. It sounded a lot like “I care about the pets, and if you guys did too then you’d do what I’m suggesting.” I don’t think it won people over.
To have a productive conversation with veterinarians about access to care, you must recognize that they have made significant sacrifices for their patients and manage a level of complexity and responsibility that people who haven’t practiced medicine often overlook. Specifically, avoid framing the discussion as if you are an enlightened “champion” and they simply “don’t get it.”
The conversation around access to care is too important to be derailed by miscommunication. My hope in writing this is not to shut down discussions about the rising cost of veterinary medicine, but to encourage a clear-eyed understanding of the profession’s reality. By acknowledging the financial constraints of most practices, respecting the pressures of organizational protocols, and steering clear of insulting, champion-like language, we can move past the pitfalls and create a “bigger tent” for people with solutions to come together. The future of care is collaborative; let’s ensure our dialogue is, too, by applying contextualized solutions to real world veterinary practice.
