Editors' Guest: There isn't much of a market for buggy whips

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Today's veterianry practice needs an overhaul, much like when the internal combustion engine changed practice in the past.

About 100 years ago, veterinarians were playing a death knell for the profession as they knew it. Veterinary medicine's foundation rested on equine practice, and internal combustion engine development signaled an end to horse-drawn vehicles. With no horses to care for, what would veterinarians do for a living?

Draft horses Monty and Prince make a delivery from the brewery-a once commonplace service. (Photo courtesy of Dr. Paul)

Fortunately for us, our predecessors reinvented the profession to focus on production and companion animals. But in the following years, several farming and production changes have all but eliminated the family farm as a viable industry. Swine, poultry, and beef and dairy cattle production have largely become the purview of consolidated farming and reduced the number of veterinarians in production medicine. Increasingly, these veterinarians have shifted their services from treating individual animals to providing herd health services and consultation. Those who have failed to adapt have struggled and become less relevant.

During this time, companion-animal medicine prospered. The strengthening human-animal bond and change in the role of dogs and cats in society led to greater educational emphasis on companion-animal care. The understanding and treatment of diseases, increased development of vaccines, advances in parasite control, and advent of professional specialization have resulted in a healthier and better-cared-for pet population.

TODAY'S INTERNAL COMBUSTION ENGINE

Veterinarians primarily provide diagnostic services, therapeutic care, pharmaceutical and nutritional products, and information. With the advent of alternative electronic sources for these services, veterinary medicine is again faced with our own version of the internal combustion engine—the Internet and a fragmented profession. In the past, pet owners sought advice, information, care, and products primarily from their veterinarians. The veterinarian was a resource and a friend. Unfortunately, that relationship has been eroded in no small part because of the rising complexity and cost of veterinary care.

With the universality of the Internet, pet owners can now obtain information about problems that once took them to their veterinarians for answers. From the Internet, pet owners learn that many minor illnesses will resolve without treatment, and many more can be managed with modest intervention such as antidiarrheals, antihistamines, and dietary control. The result is a lack of client-veterinarian interaction along with a demonstration that the pet seemingly didn't need the veterinarian. In many cases, veterinarians see only significant problems, and those patients are then frequently referred to a specialist for care. This leads to a mistaken perception that clients can eliminate their interactions with primary care veterinarians and go directly to specialists.

MORE OBSTACLES IN THE ROAD

In addition, wellness services such as surgical sterilization and vaccination are readily available at animal shelters and mobile clinics. And with early spay and neuter and increased adoptions of older pets, surgical sterilization is frequently performed even before a pet is obtained. The result is that fewer dogs and cats are being sterilized in private practices.

Parasite control products are widely available at retail markets and from Internet pharmacies—often at prices private veterinary practices have decided not to compete with.

Furthermore, discount pharmacies and super stores are now providing veterinary prescription services at deep discounts compared with clinic pharmacies. Many states require that veterinary clients be given the option of having prescriptions filled at local pharmacies.

After the AVMA, AAHA, and AAVMC commissioned the KPMG study "The Current and Future Market for Veterinarians and Veterinary Medical Services" in the United States just over 10 years ago, it was said that the demand for veterinary care was rather inelastic (rising prices for goods and services would not result in decreased demand for these services) and that price sensitivity was not a major force when pet owners selected a service provider. But recent surveys and studies have indicated that inelasticity has faded.1 Blame declining visits if you will on the economy, but in many cases veterinary care has become a commodity, and even veterinary-client relationships are increasingly susceptible to the clouds of cost.

TAKING BACK THE REINS

How will the veterinary profession respond? We can't keep selling buggy whips and compete on a commodity basis. We must reinvent, repurpose, and refocus on the things veterinarians can't be beaten on—relationships and communication.

While we all agree that new medical and surgical technology, diagnostic advances, and the achievement of successfully treating severely injured or ill animals are tremendously exciting, we must remember that the training and education we've put into those things is hugely disproportionate to the energy we put into advocating for veterinary healthcare compliance and communicating with each client every day.

It is time for veterinarians to put those buggy whips away and focus on appropriately pricing medical services, competitively pricing products, and communicating the value—rather than the price—of veterinary care.

Michael A. Paul, DVM, is the former executive director of the Companion Animal Parasite Council and a former president of the American Animal Hospital Association. He is currently the principal of MAGPIE Veterinary Consulting. He is retired from practice and lives in Anguilla, British West Indies. Follow him at Twitter.com/magpievet

Michael A. Paul, DVM

REFERENCE

1. Bayer Veterinary Care Usage Study: The decline of veterinary visits and how to reverse the trend. Bayer HealthCare, 2011. Available at http://www.bayer-ah.com/nr/45.pdf.

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