Vets Making House Calls

By Amy Fernandez

This never-ending recession has reshaped countless aspects of the economic landscape. Among other things, many formerly reliable professions have gotten a big shakeup. Small animal practice is a perfect example. For decades, it has been the preferred choice for vet school graduates. In spite of a glutted market, a private practice in a major city guaranteed financial security and a comfortable lifestyle.

That has slowly changed over the past few years. Many factors played a role, but the bottom line was that dreaded combination of rising costs and stagnant wages. Vets began raising fees to cover skyrocketing overhead and expenses. Owners, in turn, began scrambling to afford veterinary services that suddenly became unmanageable. For both, it became a no-win situation.

A significant number of people began to forego pet ownership as they downsized their budgets and cut nonessential expenses. Others began making the heart wrenching decision to euthanize an ailing pet rather than breaking the bank to pay for costly treatment options. Most significantly, for the first time, an unprecedented number of owners began deliberating before making any financial commitment about veterinary care. Rather than accepting professional recommendations without question, they began shopping around, comparing prices, haggling over bills, and researching treatment options via veterinary internet sites.

For small animal practitioners, this was an unprecedented development. From the start, this veterinary specialty was built on that indefinable emotional bond that overrides pragmatic considerations. A century ago, an ongoing demand for such an unnecessary service seemed unlikely. Skeptics revised those dire predictions as it rapidly ascended to become the profession’s bread and butter. Therefore, it’s understandable that many small animal vets were caught off guard by this sudden turnaround, even though it mirrored the conservative approach that consumers began applying to every purchase.

Inevitably, these changing attitudes hit the mainstream media. For instance, last January, The New York Times ran a feature story on reconstructive surgeries for pets. These innovative procedures certainly qualify as medical marvels, but that’s not what triggered the biggest reaction from readers. It was the five figure price tags attached to them. Media coverage culminated in the notorious 20/20 exposé last November 22. It did more than suggest that some veterinarians overcharge clients. It questioned every aspect of the business from routine procedures to the value of some tests that vets consistently recommend. In other words, this 12 minute segment got down and dirty about ethics and consumer fraud. It sparked immediate outrage from every quarter of the profession. But the resulting barrage of blogs, articles, editorials, and online petitions didn’t elicit an apology from ABC. Instead, the network issued a bland noncommittal response stating their responsibility to educate consumers and provide them with tools to make the best decisions about veterinary care.

The ensuing verbal free-for-all has not abated and I don’t intend to comment on the journalistic integrity of the writers or their sources. The story wasn’t perfect, but it accurately reflected an unsettling undercurrent in consumer attitudes about veterinary medicine. The reactions from veterinarians varied. Along with predictable indignation, discouragement, and denial, a few of them acknowledged it as another sign of changing times. Although this profession is becoming more of an economic challenge, plenty of veterinarians wouldn’t trade it for the world. Instead, they have honed their skills and explored new ways to market them.

An innovative angle often makes the difference between success and failure. But in this case, one of the most exciting developments cannot be called innovative by any definition – the veterinary house call. In fact, it’s a return to the profession’s traditional roots. Before dogs and cats revised the business landscape, horses and livestock were the mainstay of most practices. Veterinarians traveled to their patients. House calls didn’t require professional referrals, current records on file, or prior appointments for each animal. Admittedly, legal risks and productivity constraints discouraged this approach. However, it’s inherent flexibility provided intangible benefits that never merited formal acknowledgement. They disappeared without notice, but the lingering impact of that loss has never dissipated.

Although the house call disappeared from the menu for most small animal practitioners, the demand never abated. Decades later, a few trendsetters have rediscovered this dormant market. And it’s much larger than previously suspected because, as it turns out, money isn’t the only factor that can undermine the demand for veterinary care.

Normally responsible owners avoid vet visits for a multitude of reasons. In addition to time constraints, many of them dread the experience of transporting an unwilling animal to the vet and coping with its increasingly uncooperative behavior as the ordeal progresses from waiting room to exam room. Owner anxiety often matches that level by the time they reach the billing office. For large dogs or geriatric owners, simply transporting a pet is a major difficulty. Needless to say, going to the vet is always complicated for anyone without a car. Convenience and accessibility has substantial consumer appeal, but a new revenue source may not be the only benefit that veterinarians derive from house calls.

The inescapable informality of a house call resets the dial for the doctor/patient relationship. Frightened, defensive, unwilling patients are a routine complication for every veterinarian. Treating an animal in its home territory very often minimizes the stress and intimidation of these encounters – for both pet and owner.

When veterinary medicine moved from the farm to the office, it introduced an element of formality that comes with any professional environment. Technology continues to refine diagnosis and treatment protocols, as well as adding another dimension of clinical detachment to the process. At the same time, effective medical treatment remains an intangible balance of art and science, and patient input is essential. Admittedly, the resulting communication barriers in client/doctor relationships are not confined to the veterinary profession. But for them it has always included the added challenge of relying on indirect information provided by owners.

Because of this, breeders have always insisted on a good working relationship with their vets. Even though it can make a tremendous difference in the outcome, a large proportion of pet owners have become accustomed to accepting much less from this professional association. They’re hesitant to raise questions or ask for clarification. Inevitably, inconclusive, unsatisfying interactions set the stage for unreasonable expectations, buyer remorse, and all the fun that comes along with consumer dissatisfaction.

Good communication alleviates those owner concerns before they morph into misunderstanding and mistrust. It also makes it easy for vets to evaluate the potential value of information provided by owners. It doesn’t always jive with their preliminary diagnosis; it could be relevant to the outcome. Of course, the house call also includes a firsthand look at the animal’s environment, and direct observation could also reveal useful details that owners might overlook, dismiss, or deny.

Despite the fact that it can become a major obstacle to effective diagnosis and treatment, genuine communication is no longer an inevitable feature of the veterinarian/client relationship. Easy informality qualified as one of the intangible advantages built into the old-fashioned house call. Although it doesn’t get much emphasis today, the immediacy and unpredictability of a house call also demanded a bit more resourcefulness and creativity. Those experiences sharpened crucial diagnostic skills that defined a great vet long before the advent of modern technology.

Possibly, the modern house call is destined to disappear in the wake of the economic recovery. Even so, I hope that some aspects of this trend have a lasting impact.

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Posted by admin on Apr 11 2014. Filed under Current Articles, Featured. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.