We’ve reached an “interesting” juncture in pet health care. I placed “interesting” in quotes to remind readers of this ancient Chinese curse: “May you live an interesting life.” However we characterize the model of veterinary medicine or pet health care in the era of 1980 to 2000 (maybe 2010), it’s changing before our eyes. Let’s summarize current trends (2020 to the present).
- Veterinary practices have enjoyed year-over-year revenue growth, notwithstanding fears in March 2020 that COVID might knock the wind out of pet health care’s sails. Revenue in 2020 topped 2019, 2021 topped 2020, and 2022 topped 2021.
- Inflationary pressures accelerated in 2022 and remain in 2023, shrinking margins across the pet sector, especially in health care.
- Pandemic adoptions emptied many (not all) animal shelters. As a result, 23 million new pet dogs entered the American family culture. Now, however, veterinary staff shortages and inflationary cost pressures are driving families to relinquish pets at rates that should concern everyone.
- Veterinarian and technician shortages were debated for a moment before the recognition formed (begrudgingly in some cases) that we face a chronic and acute shortfall.
- Telemedicine in the world of pets is joining human health care as a practical alternative, yet it faces fierce resistance from the American Veterinary Medical Association and state VMAs in sync with the AVMA. Unfortunately, the connection between staff shortages and a pet owner’s ability to get veterinary appointments hasn’t impacted trade association opposition to the telemedicine VCPR, even with guardrails in place or proposed.
- Midlevel professional programs are finally the subject of national discussion and experimentation after 60 years of success in human health care with physician assistants and nurse practitioners. However, the AVMA and most state VMAs resist such reforms. Nevertheless, the Lincoln Memorial University College of Veterinary Medicine presses on with its new online master’s degree in veterinary clinical care for credentialed veterinary technicians. Colorado State University does the same with a veterinary professional associate (VPA) initiative involving a host of Colorado organizations.
- As professional burnout and wellness issues fester, the profession struggles with how to respond at the macro and micro levels. Many initiatives are underway at a micro level to support veterinary professionals, but we must consider macro or systemic solutions.
- State legislatures in 2023 are chock-full of proposals affecting veterinary practices, licensing, telemedicine, staffing, access to care, pet ownership, pharmaceuticals and more. The trends above are on the minds of policymakers.
What are we to make of all this? Let me suggest five places to start.
1. The Younger Generations
Thank God for millennials and Generation Zers, who now own 50% of U.S. pets. They keep demanding more and better veterinary health care, services and products, a problem every profession should welcome. However, the pressure is on the animal health and services industries to deliver solutions, starting with addressing employee shortages and alternatives for providing medical care to pets and guidance to their owners.
Every veterinary organization, including colleges, should have people working to understand the new, dominant cohort of pet owners better. They are the future, and saying, “No, you cannot have pet health care the way you want it,” won’t suffice.
Audrey Wystrach, DVM, managed and built veterinary practices across the West and recently launched the Petfolk network in the Carolinas and is expanding into Florida. Here’s her take:
“We are living in the age of the empowered consumer who demands convenient locations, virtual care, inviting hospitals and improved efficiencies. Pet owners expect data and connected technology to optimize all aspects of their lives. Driven by demographic, economic and technological change, society is experiencing a transformation in the way consumers interact with businesses — the way we do banking, hail transportation and book lodging. All have moved to digital. Flipping the model from hospital-centric to customer-centric and technology-forward is my passion, and it works. We must recognize that the balance has tipped in favor of the client.”
2. Rules and Regulations
Veterinary practice acts and veterinary medical board regulations are increasingly prescriptive in the United States. You might be surprised how widely state practice acts and boards vary in their approaches.
We should ask these questions:
- Is more prescriptive better than less?
- Should we place more trust in education and board certification so that we devote less energy telling veterinarians how to practice?
- Would any of the emerging challenges and opportunities be handled more efficiently if we followed other professional licensing models and provided greater latitude to veterinarians?
3. License Portability
Is it time for veterinary medicine to follow other professions and make multistate licensing (dare I say universal?) a reality? Or at least make it realistic and manageable for licensed veterinarians to practice in additional states?
With population trends bubbling nationwide, meaning families and pets are moving at a record pace, don’t we have a duty to enable veterinarians to do the same to address client needs? Shouldn’t veterinarians have the right to choose where they are licensed if their records are clean and they passed the North American Veterinary Licensing Examination? If we still require a state-specific jurisprudence exam, so be it, but nearly 20 states make it easy to cross state lines. It’s not a new model.
4. Public Policy
Isn’t it inevitable for us to dive into advocacy positions and educate state legislators on the current (and future) realities of pet health care? I find it refreshing when I remind legislators that 70% of their voters own pets and probably want more accessible medical care and advice. All legislators know how to do one thing quite well: count.
5. Vet Tech Utilization
If we evaluate the merit of highly prescriptive practice acts and board regulations, shouldn’t we consider additional services we could authorize veterinary technicians to perform? For example, could we accommodate pet owner demand for in-home hospice care and create certification mechanisms to enable credentialed veterinary technicians to handle such services, perhaps overseen by veterinarians through telemedicine? If we surveyed veterinarians and veterinary technicians, do you doubt they would agree on a list of procedures that veterinary technicians could handle safely? Each measure could reduce pressure on veterinarians, improve veterinary technician job satisfaction and make pet owners happier. That’s a worthy trifecta!
Those are just some of the issues and questions that make pet health care so “interesting.” Some might intrigue you and others irritate you, but ask yourself this: Does it make more sense to address the issues or ignore them?
I’m a lawyer, so I’m trained to look at things from every angle and to imagine how to do something differently. But I’m not sure veterinarians aren’t better qualified to do it here, considering they examine every possibility for the cause of a patient’s problem.
The only thing holding back the pet health care industry might be a fear of where the answers lead, and that’s understandable. But given millennials and Gen Zers (and their children), do we have any choice but to explore? The pet industry should be open to testing and experimenting.