© 2023 MJH Life Sciences™ and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.
Divided we fall: Nonprofit facilities and for-profit veterinary clinics seem constantly at odds
If we can't get shelter-run medical facilities and for-profit practices to coexist, veterinarians will look bad and shelters will face mounting community pressures-but the biggest losers will be pets.
There is an ongoing issue that plagues not-for-profit animal health groups, community-funded animal care facilities and privately owned for-profit practices alike. The concern, perceived or real, is unfair competition for income with private veterinary practices. Undoubtedly there are areas where the two do compete for clients, patients and funds, but in the end we are fighting a common enemy: Ongoing suffering among unwanted, feral and indigent pets.
(GETTY IMAGES/CLAUDIO SEPÃLVEDA GEOFFROY)
An inhumane history
When I graduated from veterinary school in the early '70s, many animal shelters were little more than short stay prison camps where surrendered or seized dogs were held for finite periods, typically five to seven days, for one final chance at a home. If they were really lucky, they were adopted, but many more contracted an infectious disease and died. Others were euthanized because their time was up or they were deemed "unadoptable." Commonly referred to as dog pounds, these facilities fell short in providing a true shelter environment, and though frequently associated with well-intentioned local groups, they were often anything but humane.
Back in the day, canine distemper and feline panleukopenia were rampant in spite of everyone's best efforts. Animals were generally not vaccinated until they were adopted, so many were infected before adoption. Years later, canine parvovirus emerged and wreaked havoc through communities at large but especially inside shelters. There were relatively few effective vaccines, and using them in pounds wasn't cost effective. Puppies and kittens that were adopted one day frequently returned to the facility sick or dead by the end of the week. Parasites were common in part because effective control and prevention products were not available. Entire litters of puppies and kittens often died or were euthanized.
Pounds were generally operated and funded by municipal and county agencies using adoption and pet licensing fees as a resource in addition to some private donations. Euthanasia was often inhumanely conducted using improperly operated decompression chambers, carbon monoxide poisoning, electrocution, intracardiac injections or guns. Some of these methods were unapproved, few were properly supervised, but all were widely practiced.
Millions of animals spent their final days under the worst of conditions and were euthanized using less-than-humane methods. Thankfully, things have changed.
Later, animal welfare groups like the ASPCA, The Humane Society of the United States and others shifted the emphasis from simple population control to adoption. So while charitable or not-for-profit veterinary facilities are nothing new, they have evolved from yesterday's pounds to true, modern shelters that focus on placement rather than elimination. In fact, some dedicated advocates are so successful at encouraging adoption that there are not enough puppies and kittens to fill demand. Shelters and adoption facilities sometimes resort to importing animals from other communities or from overseas, bringing them from smaller communities to metropolitan facilities where adoptable pets are in short supply. Increasingly, facilities operate as no-kill shelters where animals are not euthanized after some arbitrary holding period—or not at all. Shelters have truly changed in the past 50 years, not just philosophically but also in terms of their functional scope.
Rise of the full-service shelter
Early on, shelter facilities enlisted the support of sympathetic, local veterinary practices that provided sterilization and care for adopted pets at reduced fees. As communities, small community groups and even celebrities championed support for humane shelters, many organizations developed their own medical facilities for performing surgical sterilization and immunization, primarily on resident animals that were placed for adoption. But these facilities eventually began to treat pets from the community at large, rather than referring those procedures to private veterinary clinics that had worked with the shelters in the past.
In the beginning, low-cost or no-cost care was provided primarily to families that might otherwise not be able to afford it. Today, many animal shelter facilities have further expanded their operations to become full-service hospitals, providing advanced levels of medical care, products and other services not only to pet owners with financial limitations but also to the general public in direct competition with veterinarians in private practice. How did that happen? How did the tension that has existed between veterinary practices and not-for-profit facilities reach a level of animosity? The truth is, there is plenty of blame to go around.
While the primary driver for both shelters and private veterinary practices has always been preventing and alleviating animal suffering, there used to be a clear division of efforts and resources in that pursuit. Not-for-profits focused on providing shelter and an opportunity for unwanted pets to find homes, while private practices took care of the pets' medical needs. Now shelters have expanded into the arena of providing cradle-to-grave medical care to all pets, frequently providing the same services as veterinary practices in a competitively unequal environment. Both organizations ascribe to the same commitments, but the primary difference is that private practices invest millions of dollars of their own resources with no tax-free status and no donations from charitable efforts, while shelters receive tax-free charitable donations and do not have to pay taxes on their own profits. It is no wonder that veterinarians may resent not-for-profit efforts.
On the other hand, veterinarians were often unable or unwilling to provide care for illness and trauma at reduced fees. They often receive little payment and no tax advantages by doing so. Leaders in the shelter environment felt they had no option but to offer medical care to low-income pet owners with little to no fee. Unfortunately, economic realities led shelters to provide care to all pets at a reduced fee, even if the owners were capable of paying for care. So what began as a spay and neuter facility eventually evolved into a full-service hospital. This compounded the brewing resentment and the competition for clients who could pay for services. In some communities and states, relationships between private practitioners and not-for-profits have deteriorated to the point that legal action is imminent. Veterinarians will certainly look bad, shelters will be forced to defend legal and community pressures, and ultimately the losers will be the pets that need care.
Yet some communities have managed to walk the line between shelter-provided care and for-profit practices. How can these two groups come together to serve everyone's needs and interests so that low-income families and unwanted pets in need of service receive good care without directly competing with individual, privately operated clinics?
First, not-for-profits must do some level of needs assessment. This proof of eligibility need not be an overwhelming or embarrassing task. Proof of unemployment, residence in low-income housing or qualification for the Supplemental Nutritional Assistance Program may be all that's required. Those who do not qualify would receive no more than urgent care and be referred to a local veterinary practice. On the flip side, in an effort to keep not-for-profits from building flourishing medical facilities, veterinarians might consider providing care on a sliding scale to these same owners who were screened by the shelter.
Every community is different. There is no one solution for all situations, but communication and collaboration have, in many communities, resulted in successful cooperative efforts to meet everyone's needs. It requires a simple commitment: Start where you are and do what you can. Let a spirit of shared vision develop, work with mutual respect and focus less on the process and more on the goal: to provide appropriate care for as many animals as possible.
Dr. Michael Paul, @mikepauldvm on Twitter, is a nationally known speaker and columnist and the principal of Magpie Veterinary Consulting. He lives in Anguilla in the British West Indies.