Bob Lester
DVM
Creative Disruption columnist Dr. Bob Lester is the chief medical officer at WellHaven Pet Health, a former practice owner and a founding member of Banfield Pet Hospital and the Lincoln Memorial University College of Veterinary Medicine. He serves on the boards of Pet Peace of Mind, WellHaven Pet Health and the Lincoln Memorial veterinary college. He is president-elect of the North American Veterinary Community.
Read Articles Written by Bob Lester
As many as half of U.S. pets won’t visit a veterinary practice this year. The last Idexx Laboratories data I saw indicated that 1 in 3 dogs and 3 out of 4 cats will not cross our threshold. That’s tens of millions of animals. So, why aren’t pet parents seeking veterinary care? The main culprits: high costs and inconvenience.
America’s love affair with pets continues to grow. There are now more four-legged children than two-legged. Pets are magic. They unite us, heal us, keep us healthy physically, emotionally and mentally, and make us more human(e). My prescription for all that ails our country is to adopt two pets and rediscover connections and unconditional love.
COVID-19 accelerated society’s appreciation of the benefits of having family pets. Pet numbers are up, veterinary visits are up, pet spending is up, shelters are emptying, euthanasia is down, and pet lifespans are up. In addition, veterinary team compensation is up, supply costs are up, appointment availability is down, and fees have had to go up.
A consequence of all the abundance is a mismatch between the rising demand for our services and the undersupply of veterinary professionals, which further raises the barriers to care.
Our profession risks becoming a service available only to the wealthy. Every family deserves to benefit from a pet regardless of income. Veterinary care costs money, which must come from somewhere.
Overwhelmed veterinary professionals don’t want to turn away clients; it conflicts with their oath. However, doing so has become necessary to spare our teams from burnout, compassion fatigue, exhaustion and worse. We must care for ourselves before we can care for others. That’s a difficult lesson for many of us.
What can we do? Ever the optimist, I see new and promising practice models that would lower the barriers to care. Let’s tear down this wall, or at least knock a few bricks from the top.
Here’s my list of 15 current or near-future models that would help more families benefit from veterinary care.
1. Walk-in, Limited Service
Practices delivering wellness and chronic care without the overhead costs of surgery or hospitalization fill a convenience and value niche in many communities. One brick in the wall is removed.
2. Spectrum of Care
Do the outcomes differ between gold-standard veterinary care and a more value-conscious style? Are we overprescribing gold-standard care to the extent that we inadvertently shame and discourage clients? Should we feel guilty if we don’t offer the gold standard? Color me guilty. A spectrum of care approach might better address clients of limited means, lowering the barrier to care. Bye-bye, brick.
3. Veterinary Nurse Models
In several states, veterinary technicians under indirect veterinarian supervision can provide wellness, preventive and chronic care. How cool is a primarily veterinary nurse delivery system? Pet owners have learned the value of non-physician health care in human medicine. It works for people, so why not for pets? One more brick is gone.
4. Wellness Plans
Millennials, our dominant consumers, like subscription service models. Wellness plans help pet owners budget for preventive care. Best of all, pets on wellness plans live longer, happier lives. A PetSmart Charities study from several years ago showed that families at the lowest income bands could spend $216 a year on veterinary care. Could veterinarians or veterinary nurses deliver core vaccines, dewormings, education, a physical exam and virtual follow-ups for $18 a month? I bet they could. If the roughly 60 million pets in households with incomes under $25,000 spent $216, we’d find nearly $13 billion in unrealized revenue. Several more bricks fall.
5. Urgent Care
The need for care that’s not daytime general practice or overnight emergency is growing. Urgent care consumers get increased access at a typically lower cost. Toss those bricks.
6. Shelter and Nonprofit Practices
Shelters are busily reinventing themselves, turning from placing homeless pets — huge strides have been made in solving pet overpopulation — to embracing public education, animal welfare, forensics, wildlife and community veterinary practice. These low- or no-cost practices fill a vital need of underserved pet parents. Look out below, brick.
7. Employer-Subsidized Care
With the increasing competition for good employees in all sectors of the economy, employers are starting to add veterinary care to their elective benefits menus. How cool is that? Bricks away!
8. Mobile Clinics
Delivering care to where it’s needed further lowers the barriers. Driving a cat to a veterinary practice is hard enough, but imagine taking the pet on public transit. Another brick off the wall.
9. Uber Pet
Check out the service. The concept was trialed in Australia just before COVID hit. Another brick crumbles.
10. Retail Vaccine/Wellness Clinics
Talk about convenience. Vaccines and preventive care at your nearby grocer, Walmart, Tractor Supply or pet store. Bricks be gone.
11. AlignCare
Under the leadership of Dr. Michael Blackwell at the University of Tennessee’s Program for Pet Health Equity, AlignCare is working to improve underserved families’ access to veterinary care. The One Health system provides subsidies and mobilizes community resources. Bravo! More bricks eliminated.
12. Telehealth
What is more convenient than veterinary care in the palm of your hand? It’s time to embrace a virtual veterinarian-client-patient relationship. Arguing for an in-person VCPR is like arguing for the buggy whip. Not only is the whip unnecessary, but we aren’t riding horses anymore. Embrace the future. From bricks to clicks.
13. The Connected Pet
Imagine where we’ll be in a few years. Consider:
- Pets with wearable or implantable sensors that track motion.
- Cameras in the home that read a pet’s facial expressions and gait.
- Mats and bowls that monitor weight and food intake.
- Litter sensors that check urine.
- Water bowls that track consumption.
Artificial intelligence could take all that data, note trends and anomalies, and flag the veterinary professional. Imagine millions of data points monitoring a wealth of key health parameters. The future is exciting. More bricks disappear.
14. Pet Health Insurance
While I’m not a big fan of reactive care when proactive preventive care can accomplish so much, pet insurance has a place in lowering barriers to care, especially with illness care. More bricks chipped away.
15. Tax Savings
Knowing that pet ownership can reduce obesity, childhood allergies and mental health challenges, simultaneously lowering the cost of human health care, wouldn’t it make sense to partially write off veterinary care on a tax return? Wishful thinking? Probably, but why not get rid of that brick, too?
Our profession has largely focused on high-income families, while significant numbers of pets do not receive veterinary care. Everyone wins if we have a wider variety of veterinary business models. We can take advantage of the huge economic opportunity and support an enormous societal health benefit.
I remain optimistic that we can better meet the needs of pets and pet owners of every income band. Let’s continue to innovate, adapt, educate and prosper.
The Berlin Wall was thought to be unbreakable; it wasn’t. Barriers to veterinary care can be broken, too. Let’s work to tear down the wall one brick at a time.
CARE PACKAGES
The Veterinary Hospital Managers Association asked members about the preventive care products or services included in their practices’ wellness plans. The top four answers in the 2021 survey were in-person physical exams, core vaccines, rabies vaccines and parasite testing.