Many practices had a significant spike in veterinary visits during the pandemic, to the point where they were stretched thin in serving their current clients’ needs and stopped taking on new clients. That trend is now reversing; several reliable veterinary data studies have shown a decline in practice visits and/or invoices over the past 12+ months.
This trend seems to be getting a little lost in some of the other issues we are dealing with, particularly the ongoing difficulty in hiring doctors and other team members. Should we be paying more attention? Absolutely; any business that is seeing a fall-off in demand for its core products and services needs to be concerned.
One question that comes up whenever this decline gets talked about is whether this is a decline in total veterinary visits or are visits just getting spread out over more hospitals because pet owners have more options? No doubt it’s both but I believe much of it is due to a conscious choice by pet owners to manage their spending. This will, of course, vary by community; every practice needs to be up to date with the changes in veterinary offerings in their area and, when clients drift away, understand why they are leaving.
I don’t think, however, we, both as a profession and as individual practices, can ignore the impact the increasing cost of veterinary care has had on pet owners’ decisions about whether to take their pet to the vet less frequently (or at all) and the level of care to provide.
Recent data from the AVMA and Vetsource has shown that the single biggest contributor to revenue increases in practices over the last few years has been the increases in fees charged to pet owners. The proportion of revenue increase due to practice fee increases was over 2X the amount due to actual patient and visit increases in 2022 and even greater in 2023 and 2024. I don’t believe the magnitude of practice fee increases seen over the past couple of years is sustainable and is actually causing long-term harm to pets, pet owners, practices and the profession. At least some of the increases are legitimately needed to cover the increased amounts practices are having to pay for the goods and services needed to run their business but a certain amount of these fee increases are dropping straight to the bottom line. There is nothing wrong with this as long as there is no negative impact to the practice or profession but in many practices there is such an impact. Practices need to make changes, not only to protect themselves but to keep the profession healthy.
I recently heard someone at a veterinary conference talk about a young guy newly graduated and entering the workforce with an annual salary of $75,000. He very much wanted a dog but didn’t think he could afford it until he had received a sizeable raise.
I don’t know this person’s personal circumstances—he may live in a HCOL area like Manhattan or be the sole support of his aging grandmother but the idea that you couldn’t own a pet with a salary of $75,000 personally shocked me. To put it in perspective, $75,000 is almost two times the average per capita income in the US.
Of course, veterinary care isn’t the only component of the cost of pet ownership but it can be a big one, particularly when a pet gets sick or injured. My concern is that it’s hard for a business or an industry to lose the image of being “expensive” once it gets that reputation; this can turn customers away even before they give a particular business a try. Offering only “expensive” options also opens the door to other non-veterinarians entering the profession and offering some components of care at a much lower rate. Most of us can remember the long-gone days when medications were not available anywhere but at veterinary practices. More recently, I read a brief article in The Fountain Report about pet owners using technological alternatives to track pet health instead of scheduling regular health checks. If our goal as a profession is only to aim at “rich” pet owners who are willing and able to pay for gold standard care, we may not care about the “rich” image but we need to be clear this is the route we want to go.
Leaving aside the inevitable argument about whether or not someone “should” own a pet at a certain income level, you can’t get around the fact that many people with incomes lower than $75,000 do own pets and will continue to do so. It’s not the responsibility of veterinarians to make sure every pet gets everything needed but surely we have some responsibility to not make veterinary medicine only available to the rich?
The concept of a “spectrum of care” has been talked about a lot in the last few years as a way of dealing with access to care. While limited access to care can be due to a number of different reasons (veterinary deserts, lack of transportation, etc.); cost of care is no question a large component. Offering a “spectrum of care” is a critical way of solving a number of problems, including declining visits, both from a profession-wide perspective and from an individual practice perspective.
The concept of a spectrum of care when applied to the profession means there is a range of practice models available in all communities from low-cost, limited care practices all the way up to specialty care hospitals with a wide variety of practice types in between. This continuum of care means a much wider number of pets and pet owners get the care they need and practices have more customers. For this to happen, our profession has to value the idea that veterinary practices offering basic care are just as important as those offering the gold standard of care and we need to educate veterinarians about the benefits and career satisfaction to be found in offering this kind of care and in how to do it well and still have a profitable practice.
At the individual practice level, offering a spectrum of care means the practice itself regularly offers a continuum of care to pet owners depending on their needs, desires, and financial capabilities rather than only making possible or expecting all clients to want and agree to a gold standard of care; again, this expands the number of pet owners choosing to receive and pay for veterinary care. It should, of course, go without saying that there is ALWAYS a minimum acceptable level of care upon which the upper levels of the continuum are built. It also needs to be understood that this doesn’t mean practice profits have to be lower; it just means those profits are generated differently.
Declining visits can, of course, occur for a variety of other reasons beyond cost and increased care choices—common solutions, depending on the problem, have traditionally included cleaning up client service problems, improving the client experience and increasing client education efforts to better communicate to pet owners the value of what the clinic has to offer. These continue to be excellent ideas depending on what issues an individual practice is facing.
However, focusing on offering a wider spectrum of care allows practices to help those clients who for whatever reason are making leaner choices in how they spend money. Being able to provide care results in a more satisfactory experience for both pet owners and practice team members. The concept of a spectrum of care isn’t entirely new but definitely one that deserves continued attention and greater implementation in practices as we deal with economic uncertainly, declining visits and the increased cost of care.