By making many procedures both optional and more cost-efficient, rural small animal practitioners have been able to satisfy
their own clients in addition to visiting urban pet owners seeking more cost-effective care. Because of lower overhead, greater
distances from referral centers and emergency clinics, and a less-litigious client base, they have actually handled more challenging
medical and surgical cases than many of their urban colleagues. Some have achieved remarkably profitable practices, often
in unlikely demographic locations.
The key to practice growth in today's economy is to treat clients fairly. They need to be shown empathy for their financial
hardships and given broad options on levels of care that might be affordable for them. They need to be honestly informed of
the risks associated with choosing a more moderate level of care, but they also need to be informed if the chances for a resulting
negative outcome are low.
In contrast, I believe the current small animal practice model fosters exaggerated perceptions of legal liability that serve
to rationalize the need for high and inflexible levels of care. If legal liabilities were a legitimate argument for defensive
practice methods, then veterinary malpractice insurance rates would be significantly higher than they currently are.
The stringently high standards model also creates a situation in which the human-animal bond can be abused. That is, it can
be used to garner approval for procedures that benefit average transaction fees more than patient health and cost-effective
use of the client's resources. It may feel great to bask in the glow of client adulation when these clients feel everything
humanly possible was done for their pet. But the way things are going, that feeling will be more difficult to experience in
What's more, in poor economic times, even formerly compliant pet owners begin to decline certain elective procedures. For
the most part, they observe that their pets seem to do quite well without that annual exam, heartworm test, vaccination or
blood profile. They know they're taking some risks, but they're playing odds that they start to realize are much better than
what they've been led to believe in the past. And they begin to question the cost-effectiveness of their veterinarian's previous
recommendations when times were good. Unfortunately, this scenario has already played out for far too many pet owners.
The image of our profession has been tarnished and veterinary fees have reached a level where most pet owners cannot afford
intensive pet care unless they have insurance. Though some would say fees had been too low for too long, we've unfortunately
overplayed our hand. Current fees are now both impractical and cost-ineffective for an increasing percent of pet owners and
we are losing our credibility and pet owner confidence.
In my practice I could have netted well over $200,000 had I implemented the experts' policies for better profitability. But
my conscience would not have been clear and a lot more of my clients' pets would have been euthanized.
Our market has been fundamentally changed for the foreseeable future both by external factors and our own missteps. Doesn't
the success of some rural practices mean the current model needs to be made more accommodating for pet owners? The timeless
refrain of my community's native son seems appropriate: "The answer, my friend, is blowin' in the wind."
Brian E. Toivola, DVM, lives in Hibbing, Minn. The views expressed in this commentary do not necessarily reflect those of