What Are We Doing About Access to Care?

accesstocare

Originally published in Today’s Veterinary Business.

Research into where pet owners seek services will help steer an industry dealing with not enough veterinary professionals.

Having a conversation about the state of veterinary medicine in 2022 is difficult, if not impossible, without two issues front and center: the veterinary workforce shortage and access to care. Given the data, which I’ll explore, this shouldn’t be a surprise, but what’s changed is the recognition of how intertwined the endemic problems are. Basic economics tells us that the shortage of veterinarians and veterinary technicians/nurses will aggravate the difficulty of pet owners in finding veterinary care. What’s new and encouraging are the initiatives and experiments underway to solve access to care at a fundamental level beyond the slogans. Let’s dive in.

I’ll start with Dr. Kerry O’Hara of APG/O’Hara Research and Analytics and her seminal work in September 2021. Her nationwide study was funded by Mars and shared with the Veterinary Innovation Council as it shaped its new focus on access to care. Dr. O’Hara answered the question we’ve all had (and habitually treated anecdotally), namely: How many pets (and which ones) visit veterinary clinics at least annually for their care, and what happens to pets (and which ones) that don’t visit clinics? She also posed the ultimate question: In a perfect world, how would pets receive care if finances were unlimited?

Survey participants were asked about their most often used source of pet health care. The responses:

  • Traditional veterinary practices: 60%
  • Alternatives or no care: 40%

The 40% utilize in-home veterinary visits, vaccine clinics, pop-up clinics, telehealth/telemedicine, emergency clinics, phone consultations, online chats and self-directed online research.

Breaking Down the Groups

So, 60% of American pet owners visit a clinic regularly, and 40% find alternative care. The 60% are typically white, married, suburban, Generation Xers or baby boomers, and without children at home. They spend well over $500 on a pet’s health needs each year, much more than other types of pet owners. The 40% are typically urban, unmarried, younger (millennials and Gen Zers), diverse, with children at home, and making less than $50,000 annually. They spend less than $500 on a pet’s health needs each year.

All participants also were asked how their pets would receive health care ideally. Their answers:

  • Scheduled visits at veterinary clinics: 58%
  • Alternative sources (listed above): 39%

In other words, the perfect world for each group is how they access care today. That is the huge takeaway from the APG/O’Hara study, which allows us to focus on how to upgrade alternative care rather than trying to convince pet owners to access in-clinic care.

A Rise in Virtual Care

Telemedicine and animal shelters enter the scene in two interesting ways, creating an opportunity and a problem. As pet owners encounter the new reality of being unable to get an appointment with a veterinarian in the near term, telemedicine becomes essential. Receiving no professional veterinary care whatsoever is unacceptable. Debates about the veterinarian-client-patient relationship and its requirement of an in-clinic examination are academic when appointments aren’t available.

Deb Leon, founder of the telehealth company whiskerDocs, noted at the most recent Veterinary Innovation Summit that her data (100,000 engagements annually) increasingly shows pet owners choosing virtual care, not due to its convenience but because it’s becoming, for many, the only way to access care. The marriage of necessity and convenience bodes well for the future of telehealth and telemedicine.

Meanwhile, shelters are seeing an uptick in returns and relinquishments due to the inability to access veterinary care. While economics is a factor, evidence points to a trend we could have predicted: New pet owners will grow so troubled at not being able to see a veterinarian that they will choose to give up a pet. Unfortunately, this frustrating reality joins the unfortunate fact that many lower-income rental properties do not allow pets. If your pet cannot access care and you cannot find pet-friendly housing, it’s a perfect storm where pets end up in shelters.

Funding and Testing

Two organizations are taking these issues head-on: PetSmart Charities and the Veterinary Innovation Council.

Access to care has been a priority of PetSmart Charities for more than a decade. CEO Aimee Gilbreath and I sat down to discuss the nonprofit’s current projects and where things are headed. Here are her key thoughts:

Q: Financially, what are the categories of pet owners?

A: “Only 15% of pets are in the gold-standard bucket because they have insurance or the financial means for a blank check for veterinary care. About 30% are in the basic care bucket, where they are only getting spay/neuters, vaccinations, maybe some emergency care and euthanasia care. Then we think that a quarter of pets are not getting any care. We would argue that those bottom two buckets are not adequate care.”

Q: What are the financial parameters for the full coverage of pet health needs among lower-income Americans?

A: “We had consultants calculate how much it would cost to get all those pets who are currently not getting adequate care up to adequate care. The estimate was more than $20 billion a year.”

Q: What innovations are you exploring?

A: “We are looking for clinics that we consider sustainable, meaning they provide affordable care but also cover at least 70% of their operating costs with earned revenue. We are providing them with potentially four years of support. In Year 1, they get a grant and access to a consultant to build a business plan on how they can scale and grow sustainably. They spend the first year working on that, and then they come back at the end of the first year with their business plan for sustainable growth. If we agree that it’s a good plan, then they get three years of funding to get them operating in that model.”

VIC’s Work

Meanwhile, the Veterinary Innovation Council is funding two studies, pulled together by founding member Dr. Jim Lloyd. The first study, co-funded by PetSmart Charities and Petco Love. proposes to identify and increase the visibility of common strategies for pet health care services, including exploring market segmentation and innovative business models. The results will be useful to veterinary service providers considering opportunities with a goal of enhancing access to health care in underserved pet populations.

The second study, by the Veterinary Care Accessibility Project, aims to address the complex challenges of access to veterinary care by focusing on every aspect of veterinary services and products and the levels of usage and pricing. The cross-industry board will prepare a set of recommendations in 2023 or early 2024.

Let’s hope that achievable solutions are within our grasp soon.