As a brand-new veterinarian in 1963, I thought of myself as a reasonably well-trained animal mechanic. This opinion resulted from me being raised in a household supported by my father’s skills as an electric motor repairman. While my incentive to become a veterinarian was more grounded in a love for animals, my self-image was that of a problem solver like my father, with skills to diagnose and fix broken or sick pets.
At the end of my first six months of practice, however, I was enlightened as to my true purpose as a veterinarian. This enlightenment started about a week before Christmas when pet owners I had served during my first six months began delivering Christmas presents to me at the animal hospital. I received home-canned pickles, cookies, bread, candy, liquor, gloves, knitted scarfs and other gifts, all with deeply emotional cards expressing appreciation for the care I had provided their pets.
I suddenly realized I was much more than an animal mechanic. My function as a trained and caring veterinarian was to minister to the emotional needs of people who loved their pets with an intensity that could not be explained. Unknown to me at the time, my clients had introduced me to the human-animal bond.
In 2019, the human-animal bond is more thoroughly recognized and accepted by those in the veterinary profession. To further this recognition process, it is now possible to achieve certification in the “mindful connection between humans and animals.” In fact, a growing number of veterinary practices now promote the following statement as their purpose or mission: “Our mission is to support and preserve the human-animal bond.”
As caring veterinarians, however, the fulfillment of our duty to the human-animal bond is often restricted by the fact that payment for services comes from a client’s discretionary cash. Too often, client funds are insufficient to provide adequate medical care for bonded pets. Sadly, the only remaining treatment is economic euthanasia, which is administered under the guise of ending the pet’s “suffering.”
For the veterinarian, economic euthanasia presents a huge ethical dilemma because application of this “treatment” has four consequences:
- An opportunity to apply professional skills is denied.
- A human-animal bond is severed.
- A veterinarian-patient bond is severed.
- A patient revenue source is lost.
More and more articles in our professional journals describe terms like “compassion fatigue,” “ethics exhaustion,” “chipping away at the veterinary soul,” “student debt” and “veterinary suicide rate.” On a popular veterinary forum, one veterinarian lamented, “This isn’t what I signed up for!”
If our profession is ever to conquer revenue-based problems, management efforts need to emphasize three areas to reduce the incidence of economic euthanasia and ethical fatigue:
- Client discretionary funds supplementation.
- Alternate payment source development to assist low-income pet owners.
- Utilization of an accounts receivable service to manage monthly billing requirements.
Here are six problem solvers.
1. Pet Health Insurance
Fortunately, our colleagues in human and dental medicine don’t have to deal with economic euthanasia. Beyond the legal, moral and ethical aspects of such an act, the financial problems associated with paying for medical and dental treatments are minimized by insurance.
A comparison of mean annual incomes for physicians, dentists and veterinarians (shown in the table below) illustrates this explanation. One can only imagine the financial turmoil if hospital, physicians, dentists and pharmacists had to rely on patients’ discretionary cash to pay for medical expenses. Yet, about 98% of the time, companion animal veterinarians are required to do just that.
Comparatively, as can be seen in the table, the percentage of veterinary revenue derived from insurance is very low. Clearly, the lack of pet insurance benefits to supplement pet owner funds stifles veterinary revenue.
Economic limitations due to dependence on discretionary cash impact a variety of issues, as shown in a study published in the April 2017 issue of the Journal of the American Veterinary Medical Association.
For instance:
- Reduced quality of care. This directly affects application of the so-called standards of care that our profession wisely supports and promotes. Not surprisingly, this problem occurs more frequently with specialty and referral practices than in general practices because of the higher fees required for more difficult or complex medical treatments.
- Fewer veterinary visits as veterinary fees increase.
- A higher incidence of economic euthanasia.
- Moral, ethical and emotional stresses for veterinarians and staff that “chip away at the veterinary soul.”
- Staff income limitations, which contribute to turnover.
- Reduced financial fulfillment for veterinarians, leading to quality-of-life issues and frustration over difficulty repaying student debt.
Pet insurance has been available since 1982. In recent years, veterinarians have more warmly embraced the concept but have been slow to actively recommend it to clients.
In the same 2017 JAVMA study, 84% of veterinarians surveyed felt that efforts to improve client awareness and adopt pet health insurance should increase. Yet, only 23% of veterinarians surveyed discussed pet insurance at least once with most of their clients and 44% discussed it with fewer than 10% of their clients. A substantial logic disconnect about proactively recommending pet insurance appears to exist.
2. 501(c)(3) Charitable Trusts
Charitable trusts are not new to the veterinary profession. When formed and actively promoted, they can contribute modestly to practice revenue flow, but emotionally, they are important to the mission of preserving and protecting the human-animal bond. The steps to form a 501(c)(3) are not complex, but working with an attorney and accountant to do it properly is important.
Here are suggestions for creating a successful charitable trust:
- Send the practice’s trust representatives to community and shelter adoption events.
- Mail sympathy cards that state the practice has made a donation to the fund in honor of the deceased pet. The client often will make an additional donation.
- Hold an annual fundraiser and report to previous contributors the fund’s positive effects over the past year.
- Register the trust with supermarket donation programs, Amazon’s charitable-giving program and United Way.
- Encourage donors to check with their employer about the possibility of company matching funds.
- Maintain a unique website.
3. Waggle Crowdfunding
Waggle, a not-for-profit organization, might be the only pet-dedicated crowdfunding platform that partners with participating veterinary providers to help pet owners raise money for needed care.
The concept is rather simple. When a pet presents with a medical condition requiring an unaffordable treatment, a team member can explain Waggle to the pet owner. If the owner wants to share the pet’s story with a community of possible contributors, the staff member can contact Waggle, whose professional writers create the pet’s story and post it at Waggle.org.
Waggle’s network of donors then hopefully gets involved. As the case progresses, donors are advised as to the pet’s medical status.
4. Social Media Crowdfunding
In recent years, crowdfunding has transformed traditional fundraising by helping people offer direct support to those needing it most.
One of the best-known online fundraising organizations is GoFundMe, whose website offers tools to assist individuals in describing their financial needs, uploading photos and building a community of potential givers. Because a pet’s medical needs are often urgent, crowdfunding might not be the best option, but GoFundMe offers proven ideas when medical funds are needed quickly. Learn more at www.gofundme.com.
5. Health Care Credit Cards
Practices have accepted credit cards for decades, but some pet owners do not utilize them either by choice or circumstances. These clients might qualify for credit with a health care financing company.
6. Monthly Payments
Following a trend in human and dental medicine, some veterinarians turn to accounts receivable management services to handle monthly billing. These services can generate a recurring revenue stream by handling credit authorization, wellness plan billing, pet savings accounts and collections.
No revenue loss is so certain as economic euthanasia, and no act is as emotionally devastating to both the pet owner and veterinarian as severance of the human-animal bond. Pet insurance, charitable trusts, crowdfunding, health care credit cards and in-house billing are tools available to veterinarians to either supplement a client’s discretionary cash, develop alternative sources of financing or allow deserving clients to pay for medical services over a period of months.
If veterinarians cherish their duty to protect and maintain the human-animal bond, the question about whether veterinarians are obligated to help clients prepare for expenses is easily answered.