The veterinary profession is facing some serious identity and financial issues. In a relatively short time, the KPMG Mega Study grew into the National Commission on Veterinary Economic Issues. The market projections have gone from an anticipated surplus of veterinary services to a shortage of veterinary providers and now to an underutilization of veterinary services by pet owners. It just goes to show that they don't make crystal balls like they used to.

In recent years, there has been a significant decline in veterinary visits in spite of an increase in the pet population. Client numbers per veterinarian have declined by nearly 20 percent, and patient visits per veterinarian have dropped 15 percent. Why?

The recent Bayer Veterinary Care Usage Study identified six factors at play. Of those, three are actionable. Everyone wants to point at the recession as the culprit, but we can't do anything about it . We need to face the fact that the recession is with us, until it isn't. Other external factors include competition from industry fragmentation and the fact that information via the Internet is at everyone's fingertips.

There appears to be no doubt that feline patients are underserved, and cat owners are not adequately using veterinary services. I find it interesting that this has become the most addressed of the factors identified. Why? Because it's one we can solve. It might mean some modest remodeling here, some new décor there, a better understanding of how cats respond to stress and anxiety and—voila! You have a cat-friendly practice.

Unfortunately, many cat owners think they can get along just fine without veterinary care. Typically, an owner's perception of cat care greatly differs from that of dog care. Grooming, dog park interactions, boarding facilities and training classes—these give dog owners a different perspective on what it takes to keep a pet healthy. Compare that to the perception of cat care: Feed daily.

My point is not to discourage becoming more sensitive to the idiosyncrasies of cats and cat owners. To the contrary, I think this is one of the most immediately gratifying steps we can take. However, this will be a slow change and somewhat limited in impact by the other two issues: the cost of veterinary care and the lack of perceived value.

Veterinary care is expensive. There are no two ways about it. I have often observed that, were it not for employee discounts and freebies, most veterinary staff couldn't afford proper care for their own pets. A reasonable estimate for veterinary care and food can easily exceed an average of $1,200 to $1,500 a year per dog. Cats are somewhat less costly to maintain simply because they eat less. But when you factor in annual physical examinations, required vaccinations, dental care and the occasional abscess, you're talking about a respectable amount of money, especially in multi-pet households. And these projections don't include major illnesses or injuries.

One solution is pet health insurance. Coverage has improved greatly over the years, and a number of established companies now offer coverage. Premiums are a value at $20 to $30 a month. For the more than 20 percent of consumers (over 50 million) who don't have healthcare insurance themselves, pet health insurance may be unsustainable for those families. But there are other strategies as well.

The fastest and probably least palatable way to boost client visits is to lower fees. Cost-based competition is a reality and is becoming increasingly of concern.

Consider the fact that many, if not all, veterinary services and products are available from low-cost providers. Some of these prices are so low we can't compete. Humane societies, shelters, mobile vaccine clinics, Internet pharmacies and big-box stores—all are competing to provide many of the same services and products as veterinary hospitals.