NATIONAL REPORT — In the last three years, James Dee, DVM, has seen visits steadily drop in his Hollywood, Fla., practice. In fact, the appointment calendar is wide open. "Anybody can be seen within a day," he says.

He is not alone.

Though the pet population continues to grow in the United States, fewer dogs and cats are visiting the veterinarians each year, often due to a lack of owner awareness of the necessity of annual visits and the perceived high cost of veterinary care, according to a new study conducted by the National Commission on Veterinary Economic Issues, Brakke Consulting and Bayer Animal Health.

Dee agrees. "You have to express value in what you are doing for the pet," he says. "(The client) has to realize there is value in the examination."

The Bayer Veterinary Care Usage Study was conducted in multiple stages, including a literature review, interviews with veterinarians and pet owners and finally a representative survey of more than 2,000 dog and cat owners across the United States.

The survey identified six causes for fewer vet visits, including misperceptions related to the necessity of exams, fragmentation of services, the cost of care, declining incomes and unemployment, the Internet and feline resistance.

Findings were generally consistent across demographics, Volk says, with only minor differences peppering the data. "There was a slight tendency for more lapsed visits in areas harder hit by the recession, such as the rust belt ... or by people who were unemployed or had incomes below $35,000 in the household. That reinforces the recession's impact," he says. "But really, it's an endemic problem across the USA."

Florida has been particularly hard hit by the recession, and Dee's practice has felt the effects too. Visits dropped 5 percent in 2009 versus 2008 and another 3 percent in 2010 compared with the prior year.

Because pet owners are associating visits with vaccines, available services at non-traditional clinics, such as animal shelters, pet stores and vaccination clinics, may be reducing annual vet visits. The study's backers say education is the most important tool in reversing the declining visits trend. "We need a clear mandate about what constitutes good pet care," says Dr. Karen Felsted, CEO of NCVEI.

To that end, the groups propose creating and standardizing animal-care guidelines. "There are no established guidelines for what represents good pet health care," says Ian Spinks, president and general manager of Bayer Animal Health North America.

While Volk agrees, he also points out that the frequency of visits can be addressed even before the veterinary community agrees on an animal-beneficial schedule. "The first thing vets have to do is monitor what their visits are," he says. "In interviews with vets, many don't track their visits, only revenues and average transaction charges. They're not tracking visits and don't know what kind of store traffic they have. If they don't know what it is, they don't know if it's declining or improving." However, of those who did regularly track visits, 56 percent of veterinarians reported fewer visits in 2010 versus 2009.