funded veterinary clinics, and shelter medicine programs (see 10.14 Providing Cost‐Effective Care for Those in Need).
Despite these earnest attempts to address the profession's incipient affordability crisis, the veterinary profession has as yet failed to achieve a sustainable solution. Meanwhile, the divide between the “haves” and “have nots” expands exponentially with no signs of moderating any time in the near future.
The following is a list of considerations devised to mitigate costs and address other affordability concerns.
Create and standardize tiers of care based on acceptable alternatives, allowing for a variety of standards of care (see 7.8 Providing Care for Those Unable or Unwilling to Pay). In this scenario, for example, a level one, minimal care standard could be considered ethical and legally defensible for financially stressed households.
Create a system by which individuals may be “income qualified” for lower cost services, thereby assessing affordability concerns more objectively. This qualification could provide a more practical, verifiable route for justification of a minimal standard of care.
Provide practical instruction for students at veterinary teaching hospitals to address affordability issues by advancing a breadth of diagnostic and treatment options. This may serve to address stigma surrounding reduced standards of care so that all practices, including secondary and tertiary care practices, can more readily offer a wider variety of care options (see 2.2 The Role of Incremental Care).
Provide practice management consultation services to low‐income practices and promote the concept of for‐profit community clinics to veterinarians with shelter medicine interests or public service leanings.
Establish not‐for‐profit payment plan services to help those with low credit scores to finance care.
Negotiate more aggressively with veterinary pharmaceutical companies to provide lower cost drugs and products to prequalified low‐income pet owners or in shelter settings.
Only in very specific situations will discounting be a suitable solution (see 2.11 Discounting in Veterinary Practice)
Support and promote shelter medicine and public policy programs in veterinary schools. Establish tuition reimbursement programs for students willing to practice in low‐income settings to help address these candidates' unique financial concerns.
The veterinary profession is clearly at a crossroads in its search for a meaningful, sustainable solution to this emerging crisis. The profession is undeniably well equipped with the creativity and compassion to overcome this critical issue before it affects future generations adversely, but it will need to confront it honestly and meaningfully at the highest levels of the veterinary establishment to do so. The profession is currently engaged in the early stages of exploration of this complex issue.
Pet owners are finding it difficult to pay for the more expensive veterinary services offered by an increasingly sophisticated veterinary profession, leading to what industry analysts have described as an affordability crisis.
National economic trends toward growing income inequality and the dearth of low‐cost options for veterinary care are at odds with the increasingly widespread cultural conception of pets as family members, further inflaming affordability concerns.
Veterinarians' drive to increase standards of care, coupled with the higher cost of drugs, supplies and education, among other factors, have led to the higher priced veterinary services pet owners are increasingly unable to afford.
Current solutions to the affordability problem primarily include pet health insurance, wellness plans, and financial services (credit cards and payment plans) along with a limited number of privately and publicly funded low‐cost veterinary service programs and practices.
The future of veterinary affordability rests in the hands of the veterinary establishment, where a serious examination of affordability issues is currently under way.
Reference
1 1 Volk, J.O. (2011). Executive summary of the Bayer veterinary care usage study. JAVMA 238 (10): 1275–1282.
Recommended Reading
1 ASPCA press release. Miami‐Dade County Becomes 10th Community in ASPCA Partnership. (2010). www.aspca.org/about‐us/press‐releases/miami‐dade‐county‐becomes‐10th‐community‐aspca‐partnership
2 University of Florida College of Veterinary Medicine press release. New UF and Miami‐Dade County collaboration will help homeless animals. (2016). www.vetmed.ufl.edu/2016/08/18/new‐uf‐and‐miami‐dade‐county‐collaboration‐will‐help‐homeless‐animals
3 Sullivant, A., Mackin, A.J., and Morse, D. (2020). Strategies to improve case outcome when referral is not affordable. J Vet Med Educ 47: 356–364.
2.11 Discounting in Veterinary Practice
Mark J. McGaunn, CPA/PFS, CFP®
McGaunn & Schwadron, CPA’s, LLC, Medfield, MA, USA
2.11.1 Summary
Professional service providers have been particularly vexed after the provision of their service with both (i) billing and (ii) collecting from their clients. Service providers, such as veterinarians, who have acquired a great deal of technical skill may not possess the administrative and financial background skills necessary to convey the importance of what they're providing to the actual explanation of value to clients. Veterinarians should not feel that they are alone in this particular skill set as many professional service providers such as attorneys, accountants, financial planners, architects and even physicians, among others, have long been deficient in this learned skill, and they fully recognize the need to acquire those skills. There are whole consulting industries whose sole purpose is to provide professional service providers with the skills and support to actually charge a “full” price without providing discounts, and buoy the self‐worth of the provider.
2.11.2 Terms Defined
Discount: A deduction from the usual cost of something typically
