I like to think I am pretty handy. I can put up a shelf, switch my car’s seasonal tires and bleed a bicycle’s hydraulic brakes (with some degree of swearing and covering myself in brake fluid). But I’m terrified of doing electrical work. I don’t understand enough about it to be confident that I won’t electrocute myself, burn the house down or electrocute myself while burning the house down. So, when I have a problem, I call an electrician — someone I mentally acknowledge knows a great deal more about it.
My father was a tradesman, a plumber. I’ve seen how much goes into training, certifications, insurance, specialized tools, vehicle costs and travel time (a tip of the hat to house-call veterinarians) and yet I still find myself respond with reflex second-guessing of the value when I get presented with the bill. For all the reasons I detailed above, plumbers and electricians, no doubt, feel entirely justified in their prices.
Perspectives on Veterinary Care
The unnuanced point I’m making is, should we expect pet families to view the cost of veterinary health care differently? Or, for that matter, should veterinary teams empathize with the experiences and perspectives of pet families? The immediate reaction of most people tends toward their own perspective:
- Pet family: “Every year, this bill goes up, and I feel like they’re always trying to sell me new stuff.”
- Veterinary team: “They say they want the best for their pet, but then they complain about the bill.” (Or, more likely, don’t complain but visit less often.)
Both of those experiences feel true to the individuals and are grounded in facts.
The reality is that veterinary care is getting more expensive. Between inflation, new products and services, and the increased availability of advanced medical care, we’re asking clients to pay more.
For both corporate and independent veterinary practices, the ground continues to shift under their feet. The cost of goods has seen unprecedented increases and the scarcity of veterinary labor has driven enormous increases in practice overhead. Providing pet families with the care and experience they expect requires investing in new technologies and training. All facts.
Greater Cost, Fewer Clients
While tension about the cost of care has always been (and will always be) present, emerging data should raise larger warning flags. For the past three years, data from VetSource has shown a concerning pattern: Practice revenue has increased year over year while practice visitation declined. Put simply, year after year, pet families who continue to visit a practice have been responsible for contributing a slightly larger portion of the practice revenue.
Here’s an example: Five friends go out to dinner every year. Last year, they split a $150 bill, so each was responsible for $30. This year, one friend didn’t make it, so they split the now $160 bill four ways ($40 each). The restaurant is happy because it made more revenue, but the diners feel the cost increase and may look at a different restaurant next year — or just order in.
The same pattern is playing out in veterinary practices. Each visiting pet family pays a slightly larger portion of the increasing practice revenue each year. And at the practice, net revenue has been growing (albeit not booming), so the traditional alarm bells aren’t ringing. The decrease in visits suggests that an increasing number of pet families decided they either:
- Can’t afford to pay more for veterinary care.
- Don’t see the value in what they’re asked to pay.
For practices delivering high-quality care (what they believe most clients want), is this the natural process of retaining pet owners who match the practice’s brand? After all, marketing experts have told us for years that we shouldn’t seek to serve everyone, right? The answer, predictably and frustratingly, is, “It depends.”
A New and Unsustainable Trend?
Comparing the 2023 and 2024 VetSource numbers reveals these data points:
- Per-practice revenue increasing by 2.9%
- Per-practice visits falling by 2.6%
A similar pattern has played out since 2022. So, what happens if that trend continues for the next five years? What will 2030 look like if we keep seeing similar numbers? Due to the amplifying effect of higher revenue in the face of less visitation and the compounding action of those trends year over year, the answers are somewhat staggering:
- Practices would see 15% fewer pets.
- Spending per pet would increase by 39%.
It’s impossible to look at those numbers and not be concerned about the sustainability of veterinary care, how pet families will access it and how practices will continue to prosper with a smaller clientele paying a lot more. However, I also see a silver lining: the opportunity for innovation in our industry and in communities and pet families.
An Inflection Point
The Iron Triangle is a human health care model popularized by Dr. William Kissick in the 1990s. It’s a framework that helps analyze policies, reforms and the tough decisions leaders face regarding health care delivery. The three points of the Iron Triangle — cost, quality and access — are interconnected. You can’t push one point outward (for example, dramatically increasing quality by purchasing expensive technology) without affecting the position of the other points.
Every practice makes choices, either consciously or unconsciously, about where they sit on the Iron Triangle. My observation is that most of our industry’s focus has been on prioritizing care quality over affordability and accessibility. From a business perspective, there has been little reason not to prioritize things that way. We’ve seen enormous, sustained growth, and high-quality veterinary care has attracted pet families, entrepreneurs and investors.
Veterinary medicine has traditionally been a high-growth market. However, the data shows that a portion of pet families who historically visit high-quality primary care practices can no longer justify it, the key assumption being that the cost has become prohibitive. This data, viewed through the Iron Triangle lens, doesn’t just signal a challenge; it illuminates a path forward.
Growth Opportunities in Primary Practice
The declining practice visitation trend is an expression of opportunity. It tells us that some pet families we see want an alternative and, dollars to doughnuts, that other pet families are in the same boat.
In this context, let us consider the triangle of cost, quality and access. If we’ve been dialing up quality, what would happen if we emphasized the triangle’s other points? And tantalizingly, does a new generation of veterinary tools potentially help us increase the quality of care without affecting the cost?
As a strategist, I believe any business must be clear on the unique value it seeks to provide and to whom. This is as much about identifying the things we won’t do as the things we will. Making conscious, realistic decisions about where on the Iron Triangle your business will focus and communicating it clearly to your audience will determine your practice’s fundamental identity. In this competitive niche, you can best achieve sustainable success and effectively serve your chosen segment of the pet-owning population.
I present three options.
1. LEAN INTO QUALITY
- Strategic focus: This will feel like the easiest path for many practices. It’s the market positioning they are comfortable with and how they built and staffed their hospitals. According to the data, a large majority of clients are willing to pay for the services provided. However, the strategic imperative is relentless consistency and clear value communication. If clients feel they’re paying Rolls-Royce prices, they will expect all aspects of the practice to reflect it — from the frictionless experience at check-in and the perceived value of the facilities to the depth of medical communication and follow-up care.
- Practice focus: When economic times feel lean, we’re tempted to hold back on spending. However, continued investment in their value proposition is essential for many practices. Team training, technology that enhances medical care and communication, and specialized care are necessary to continually justify the associated costs to pet owners and differentiate the practice from competitors focusing elsewhere on the triangle.
- Current state: We see this value proposition in specialty and referral care and in boutique and high-touch general practices. Practices that don’t identify with this level of service would be well-served to examine their strategy and see whether providing higher levels of service to fewer pet families is the route they wish to pursue.
2. PRIORITIZE VALUE AND AFFORDABILITY
- Strategic focus: This one targets the growing segment of pet owners seeking reliable care options that fit within a specific budget. The practice’s core value proposition centers on delivering predictable, effective veterinary care for everyday needs at an accessible price point rather than being the cheapest option overall. The strategic imperative is meeting the needs of cost-conscious clients by achieving significant operational efficiency while maintaining transparent communication about the scope and value of services.
- Practice focus: Success here demands a relentless commitment to efficiency and disciplined cost management. Key actions involve streamlining workflows, standardizing protocols for routine procedures and wellness care, leveraging technology for operational savings and efficient client communication, and optimizing staff roles for maximum productivity. This approach often necessitates consciously limiting the range of in-house diagnostic and treatment options and avoiding investments in high-cost, specialized equipment. Transparent pricing models, financially friendly payment solutions, and wellness plans are commonplace tools.
- Current state: Dedicated business models prioritizing relative value and affordability are already established in the market. Examples range from standalone or retail-affiliated clinics focusing on preventive care to dental, surgical or imaging centers leveraging efficiency in specific medical areas. Furthermore, in general practices, the growing implementation of Spectrum of Care principles directly reflects this strategic focus, emphasizing the importance of establishing the relative value of more budget-conscious diagnostic and treatment options alongside higher-cost alternatives.
3. MAXIMIZE FOUNDATIONAL ACCESS
- Strategic focus: This approach centers on extending essential veterinary care to populations or geographic areas facing significant barriers, such as distance, transportation difficulties, a lack of local providers and prohibitive costs for basic services. The value proposition is ensuring that more animals receive at least baseline preventive and primary care. The strategic imperative often involves innovative delivery models, community integration and partnerships to overcome deep-seated access challenges in targeted groups.
- Practice focus: Successful implementation frequently requires operating beyond a clinic’s traditional four walls. Key actions might involve satellite clinics or regular service days in underserved towns or neighborhoods, deploying mobile units for specific outreach, establishing accessible pop-up clinics (like community vaccine events), and forging partnerships with food banks or human service organizations. The service menus are often intentionally simplified to the core essentials, such as exams, vaccines, parasite control and triaging common illnesses.
- Current state: Examples include nonprofit clinics in low-income urban areas, mobile units serving remote rural or inner-city communities lacking options, large-scale free or low-cost community vaccine and microchip events, and basic telehealth services for remote pet owners lacking local veterinarians. Are there additional opportunities in this segment for sustainable, for-profit businesses? I would have to think so.
The Future
The Spectrum of Care often embodies finding balance. However, the market reality is increasingly clear. Attempting to be all things to all people is no longer a viable long-term strategy for general practices in urban or suburban environments. In the face of shifting client needs and economic pressures, the greatest danger lies not in choosing imperfectly but in failing to choose decisively. Strategic ambiguity risks stagnation, client confusion and, ultimately, competitive disadvantage in the evolving landscape.
Meanwhile, after consulting YouTube, I’ll inevitably pay skilled electricians whatever they charge because the value of not burning down my house is absolute. Pet families constantly face this same high-stakes calculation — cost, value and necessity. This reality presents veterinary practices with a challenge and an urgent strategic mandate: Explicitly define and communicate their unique value proposition by taking a clear stance on the Iron Triangle. Clinics can attract and retain clients who resonate with a specific promise by consciously choosing that focus and living it authentically.
Understanding my father’s plumbing overhead didn’t lower his rates, and similarly, strategic clarity about value won’t eliminate the reality of veterinary costs. However, that mindset significantly improves our ability to communicate clearly, provide vital context and shift the conversation from pure price sensitivity toward a mutual understanding of the value delivered. It builds trust and reinforces the rationale for the necessary investment in pet health, creating a far more sustainable foundation for families and practices than simply hoping clients won’t notice (or won’t mind) the rising bills.
The practices that thrive tomorrow will be those that clearly define who they serve, and how, today.
VET-FREE ZONES
A 2025 report from the telehealth company Dutch concluded that 129 million Americans — one-third of the country — live in veterinary care “deserts.” Even the high-population states of California, Florida, Illinois, New York and Texas are pockmarked with “deserts” due to a lack of access to nearby veterinary care.
WHAT PET OWNERS THINK
The recently released PetSmart Charities/Gallup State of Pet Care Study [bit.ly/3Y4Puvr] revealed that a startling 52% of U.S. pet owners either skipped necessary veterinary care in the past year or declined recommended treatment. Strikingly, even among households earning $90,000 or more, two-thirds cited financial barriers when declining care, with 33% specifically pointing to affordability issues. Another survey, from pet services booker Rover, found that 48% of owners are concerned about the rising cost of pet care over the animal’s lifetime and that 31% agree “the cost of pet items seems to be increasing more than other household or personal care items.”