In the past two years there have been many articles in the veterinary literature addressing the factors contributing to declining
veterinary visits. No doubt these factors are significant, but I believe the profession has ignored the effect of changes
in the small animal practice model and its attendant standard of care issues on many small animal practitioners for more than
a decade. Having sold my rural Minnesota small animal practice of 40 years and visited many rural practices in the past three
years as a relief veterinarian, I've had considerable experience dealing with this matter.
I want to first acknowledge that I am not a dissatisfied, overworked and undercompensated veterinarian with 46 years of bad
practice experiences "stuck in my craw." I sold my solo, profitable-and-growing, 32-hour-workweek practice for a good price
in a community with an unemployment rate of 18 percent, the highest in the state at the time. Though now retired from practice
ownership, I feel compelled to express my concerns about a profession I still love.
The past 20 years have seen many technological advances in veterinary care. And the veterinary colleges, true to their charters,
have incorporated these changes into the standards of care taught to veterinary students. These standards of care have been
adopted by small animal practice organizations and legally enforced by state boards of veterinary medicine. These changes
have forced practices to provide higher-quality care with corresponding fee increases to all clients, regardless of their
However, the money allocated to veterinary services is often a fixed item in many household budgets. As fees and standards
of care have increased, those in middle- and low-income groups have had to make difficult decisions about their ability to
afford veterinary care. And many have decided not to seek that care due to cost, leading to decreased visits in the profession
as a whole.
In contrast, many of the few practices showing recent growth are rural clinics located in small towns 10 to 50 miles from
large urban population centers. These practices are growing because they provide the more cost-effective veterinary care that
many urban pet owners are begging for.
As many 30- to 40-year veterans of rural small animal practice can attest, we've been successfully performing a host of quite
technical medical and surgical treatments for years without always utilizing many of the recently recommended procedures.
For example, take presurgical blood tests on obviously healthy adult pets. Even in human hospitals, presurgical blood tests
are not always performed on young adults—insurance companies have deemed them to be cost-ineffective and therefore do not
cover them. Another example is the all-out quest for a definitive diagnosis. In some urban practices this is a major contributor
to increased cost of pet care. But we all know that response to therapy is a legitimate diagnostic aid that also reduces the
cost of care.