A practice’s Spectrum of Care (SOC) refers to the range of patient care options that provide appropriate treatment based on each case’s unique circumstances. While not always the primary factor, finances often influence the level of care selected.
Historically, Veterinary care operated on a cash-for-services model—similar to dental or automotive care—where pet owners paid directly for the standard of practice (SOP) their companion received. In some cases, financial limitations led to denied care or euthanasia.
The earliest known Veterinary insurance policy dates back to 1890 in Sweden, primarily covering livestock and horses (fun fact!). In the U.S., pet insurance emerged later, with Veterinary Pet Insurance (VPI)—now part of Nationwide—issuing the first policy in 1982. Financing options followed, with CareCredit originating in the human dental field in 1987 and expanding into Veterinary medicine shortly after.
Despite decades of availability, pet insurance penetration remains low in North America, at approximately 3.9% for dogs and cats combined (based on recent industry reports). Financing sees higher adoption, around 25%, with CareCredit dominating and options like Cherry gaining traction.
The Problem
Mid-2020s data highlights a growing challenge: pet owners increasingly decline Veterinary care due to cost. Fewer clients are crossing practice thresholds, and common objections like “That’s too expensive” or “I can’t afford that” are becoming routine. Veterinarians are questioning whether fees have reached a point of price resistance, potentially denying patients proper care.
Rising costs for medical supplies, coupled with the need to offer competitive staff wages and cost-of-living increases, create a profit squeeze for practices.
Solution A: Good, Better, or Best
The key is to structure your Patient Care Plan (PCP) around “good,” “better,” and “best” options.
For instance, a young university student brought in his cat with a large, painful head abscess and only $125 available. The “best” approach—two days of hospitalization, full anesthesia, lancing, Penrose drain placement, rehydration, antibiotics, and more—would have cost around $1,000, far beyond the client’s means. By shifting to the “good” end of the SOC, we delivered simplified, effective care within budget. The cat returned in seven days for drain removal—perky, happy, and eating well.
This “good” option did not become the standard for all cat abscesses, but it was the right choice for that situation and client.
Solution B: Uncovering Hidden Payment Options
When clients are distraught—especially in emergencies—they may overlook solutions and default to euthanasia. Compassionate exploration can reveal viable paths.
Consider an older woman whose 3-year-old Pekingese was hit by a car, resulting in a prolapsed left eye. Her first words: “He’s been hit by a car, Doctor. I don’t have any money—you’ll have to put him to sleep.” The veterinarian quietly resolved, “Not on my watch,” ushered them into the exam room, and assessed the patient. Despite the injury, the dog was otherwise stable.
A tailored “good” PCP included chest X-rays, light anesthesia, repositioning the eye, and stay sutures—totaling $900. When the client reiterated she couldn’t afford it, the DVM respectfully asked about savings, checking accounts, or credit cards. The woman mentioned a card reserved “only for emergencies.” The veterinarian gently replied, “This is an emergency.” She authorized the care. Two weeks later, she returned for suture removal, bringing a large bouquet of flowers in gratitude. She wasn’t insulted by the DVM’s asking her about her finances, she just wasn’t thinking clearly at the time with all the options.
Today, without a credit card, we would guide clients toward CareCredit or Cherry financing.
Option C: ‘If This Were My Pet’
One of the most authentic approaches is to recommend what you, as the veterinarian, would do if the patient were your own. This minimizes financial bias and focuses on the pet’s best interests.
I recall our 5-year-old Papillon, Daisy, who developed a rare, aggressive malignant tumor in the anal musculature. Biopsy and ultrasound showed significant local invasion. Surgical removal—albeit an expensive option—would have left her with fecal incontinence, unacceptable for her quality of life. Heartbreakingly, we chose euthanasia for a dog who was 99% healthy and 1% sick.
Ultimately, the decision prioritized the “best” outcome for the patient—not the most advanced or costly care.
Wrap-Up
Work collaboratively with the client and patient in the moment: present good, better, and best options, share what you would choose for your own pet, and explore financing transparently.
Endorse pet insurance for long-term support and offer accessible financing like CareCredit or Cherry. With these tools, practices can set fair fees, deliver appropriate care, keep clients and patients satisfied, and maintain financial health—ensuring staff receive needed raises.
Action Steps for Implementing Spectrum of Care (and Ensuring Patients Get the Care They Need):
- Offer clients “good, better, and best” treatment/diagnostic options—start at the top and work downward as needed.
- Build the Patient Care Plan as if the pet were your own to foster trust.
- Explore immediate financial solutions with phrases like, “Let’s find a way to get your pet the care they need” (e.g., existing credit cards).
- Promote pet insurance team-wide, starting with new client forms: “Who is your pet insurance carrier?”
- Provide financing options such as CareCredit and Cherry.
- Don’t hesitate to downshift to “good” care—not every client wants or can afford the “best.”
- Set fees in the “just right” range—aligned with your community’s median household income (need help on this? See link below).
Struggling with unwanted financial stress in your practice? Ready to roll up your sleeves and uncover the precise reasons behind it? Click the link below to schedule a free 45-minute Practic Potential Discovery Consultation: