Three catchphrases have sparked many conversations over the past few years. One is, “We have a serious shortage of veterinarians.” (Some say we don’t.) Another is, “We support the spectrum of care” (whatever that means). And finally, “We need to address access to care,” a topic highlighted frequently in veterinary journals and at conferences. So, there you have it — the state of pet health care wrapped up in three sayings. Do these concepts live in silos, or are they connected? And if they are intertwined, what conclusions might we draw?
Former veterinary college dean Dr. James Lloyd sports a Ph.D. in economics, and he’s trained to express economic opinions and interpret economic data. This training includes a simple rule of economics: Supply and demand have consequences, and a supply shortage puts upward pressure on prices. If less of something is available, then Dr. Lloyd reminded Today’s Veterinary Business readers that the price of that “something” may be expected to increase [go.navc.com/invisible-hand-TVB]. He also conducted the most comprehensive studies to date about the veterinarian population and concluded that we face a serious shortage of them now and into the future.
No Shortage of Opinions
Could the shortages affect veterinary service prices? How do you conclude otherwise? Veterinary practices have fixed costs, and fewer veterinarians reduce the revenue needed to cover those expenses. The situation creates upward pressure on service prices, posing challenges to access to care if one believes the shortages are real.
The American Veterinary Medical Association and others challenge the existence of shortages and expect any current “blips” (their word, not mine) to be cured in the short term. That view causes shortage skeptics to question whether telemedicine, new veterinary schools and expanded DVM class sizes make any sense. Apparently, that cohort doesn’t see price pressures in the marketplace or simply chalks them up to inflation or outside factors.
But advocates of access to care, like PetSmart Charities and other animal welfare organizations, see things differently, as confirmed in the 2025 PetSmart Charities/Gallup national poll. The data revealed that about half of American pet owners (the consumers of veterinary services) avoid veterinary care or do not follow care recommendations due to price considerations. And Fountain Report revealed data from a different angle: a slow but steady decline in veterinary visits.
Is this environment driven by economic factors, as Dr. Lloyd’s analysis suggests, or should we conclude that current pet owners (over 52% of whom are millennials or Gen Zers) care less about their dogs than they used to?
Seeing no evidence of the latter, it’s difficult not to conclude that shortages either lead to fewer available appointments or drive up prices as practices lack enough veterinarians to meet client demand. As axiomatic as these conclusions seem, it’s even harder to ignore that lower-income U.S. pet owners are impacted more harshly.
Mounting Opposition
So, we reach the end of a 20-year run on Americans’ love affair with puppies and kittens. Meanwhile, the law of economics catches up — or at least catches some by surprise. Colorado voters concluded in November 2024 that the state faced a serious shortage of veterinarians and that the time was right for a veterinary version of physician assistants.
What was the AVMA’s response? It rushed out to urge every other state VMA to oppose the veterinary PA, immunizing those 49 states from Colorado voters’ bad decision. Just as the AVMA opposes starting a veterinarian-client-patient relationship through telemedicine wherever it can.
As of now, over 108 million Americans may access veterinary care initially through telemedicine. However, trade associations are determined to stop the trend. One can only conclude that those associations doubt we face a veterinarian shortage, so access to care is not an issue. If that’s true, then veterinary conferences need to pull access to care lectures from their agendas. Apparently, we don’t have a shortage, and the PetSmart Charities data was wrong.
Veterinary medicine has choices to make. Do we face a shortage? Do the laws of supply and demand apply to pet health care? Do pet owners have no problem accessing care?
Fool’s Gold
Now, we navigate to the spectrum of care, a catchphrase anchored in the economic waters of supply and demand. How’s that? If a gold standard of care exists for every medical condition, then presumably, every pet should receive it if no price pressures are at play. But we know that isn’t the case, according to the PetSmart Charities data. Nearly half of pet owners are turning down care recommendations or skipping visits altogether due to the costs.
The spectrum of care comes into play when a veterinarian is comfortable suggesting to price-constrained clients that some level of care below the gold standard is available to help their pets. That option solves the problem, right?
Such a response doesn’t seem to work because many veterinarians were never taught about care options below the gold standard. Or those veterinarians fear for their licenses if the state board learns they dropped below the gold standard, regardless of the circumstances faced.
No two state boards of veterinary medicine are the same, just as no two boards of medicine, nursing, architects or engineers are the same. State laws and regulations differ, and the membership of these volunteer boards (veterinary included) varies from year to year.
Questions about gold standards of care and what to do when a veterinarian deviates from them are challenging for state boards. Why? Because each board member may have a different opinion, and state veterinary practice acts aren’t clear about how to view veterinary behavior below the gold standard. The American Association of State Veterinary Boards is well-positioned to help state boards navigate these waters by setting best practices.
That all sounds good, I hope, but it shouldn’t sound easy. How do we define standards of care under the practice acts? Who supplies the leadership or models? Harder yet is listing and explaining the circumstances that require (or at least enable) a veterinarian to recommend and provide care that falls below the gold standard. Are they economic factors? Social factors? Geographic factors? Transportation or mobility factors? A pet’s medical factors and maybe the pet owner’s?
The list doesn’t stop, but that doesn’t mean state boards shouldn’t try and that the AASVB cannot help.
Let’s Be Open-Minded
It’s too simplistic to suggest that veterinary medicine is at a crossroads. The profession doesn’t have a single choice or a single path to take. Given all the considerations, including the laws of economics, doesn’t it make sense to test the waters with alternatives and pilot approaches? Wouldn’t we be better off as a society if the guardians of pet care didn’t respond to situations with arms folded as they scold advocates who suggest that change might be helpful?
If we look at other sectors of American society and economics, it’s difficult to identify any area that improved itself by saying “no” when alternative or different models appeared on the horizon. Not every experiment works, but every experiment also does not lead to harm and destruction. When considering the questions about veterinary shortages, the spectrum of care and access to care, why don’t we keep the door open to change?
LEARN MORE
Download the American and Canadian versions of the PetSmart Charities/Gallup State of Pet Care Study at bit.ly/44281Mi.