Euthanasia: Emotional and costly

According to Dr. Marsha L. Heinke, a DVM Newsmagazine contributor and president of Marsha L. Heinke, CPA Inc., euthanasia is a core emotional and financial issue for practices.

Every veterinarian comes into his or her practice with preconceived notionsabout euthanasia, and how much clients are willing to spend on animals beforethey stop treatment. In the latest DVM Newsmagazine survey (page 1), theaverage stop-treatment point, according to veterinarians, is $976.

And that statistic just reflects sick animal treatment. Behavior problemsremain a leading cause of relinquishment to shelters, humane societies andveterinary practices. Nationally, estimates from shelters reflect a downwardtrend in the total number of euthanasias overall, but estimates are that5 million animals are killed each year, reports Dr. Gary Patronek, directorof the Center for Animals and Public Policy at Tufts University.

But to quantify the loss to practice income is yet another story andit's like getting your arms around a cloud, Heinke explains.

First and foremost, most veterinary practices accounting systems aren'tsophisticated enough to track euthanasias. Furthermore, many statisticsare based on total deceased animals. Economically, euthanasia brings upmany, many issues including staff turnover, stress, increased anxiety becauseof client pressure, "not to mention the lost stream of income froman animal that may have been prematurely euthanized due to a problem thatcould have been prevented."

A few years ago, Heinke and Dr. Suzanne Hetts, a veterinary behavioristin Littleton, Colo., tried to quantify the cost of relinquishment to theveterinary practice for the American Animal Hospital Association. Heinkesays they found it to be a daunting task, and much of the information isreally generated from professional experience due to a lack of quality datain the for-profit sector to study death rates and specifically, euthanasiarates.

Consider these IDEXX VetConnect System 2002 statistics for age demographicswith staffs of four or more doctors per practice:

Age breakdown for dogs:

* No age specified: 12.34 percent

* Under 1 year of age: 4.64 percent

* 1 year age: 7.5 percent

* 2-5 years old: 33.73

* 6-10 years old: 27.97 percent

* Over 10 years of age: 29.79 percent.

Age breakdown for cats:

* No age specified: 18.19 percent

* Under 1 year: 4.16 percent

* 1 year: 6.66 percent

* 2-5 years old: 29.13 percent

* 6-10 years old: 24.12 percent

* Over 10 years old: 30.76 percent.

Traditionally, the client turnover rate in veterinary practice averages30 percent for many reasons, Heinke says.

From this lost client base, about 30 percent can typically be attributedto pet death loss. In other words, in a typical small animal practice 10percent of a patient base can die off in a given year. If a mortality rategoes above 15 percent, you have to ask why, she adds.

But Heinke cautions that most practice data management is not adequatelycompetent to drill down to find out how much of the mortality rate can bedirectly attributed to euthanasia, old age, trauma accidents, etc.

Heinke says that Dr. Gary Landsberg, veterinary behaviorist, has reportedthat veterinarians can lose 15 percent of canine and feline client baseannually simply due to behavior problems. The practice may not euthanizethese animals, but it could result in relinquishment to shelters.

Consider this: the average 2002 IDEXX VetConnect Systems data indicatethe average sales per client is $410. The average spent per year, per dogis about $300, and $195 per cat. If 10 percent is an accurate assessmentof euthanasia related deaths, then out of a patient base of 5,000 it representsa $137,500 loss to the practice.

If a portion of those animals are lost due to premature euthanasia, theeconomic impact is compounded year after year.

While the readily available statistics are poor on euthanasia, the pointis this: Premature euthanasia has an economic impact on practice.

"If 10 dogs are euthanized each year prematurely because of a misseddiagnostic test or even mild behavior problem, it still represents $3,000a year, compounded with its life expectancy," Heinke explains.

"There is a psychology about being a veterinarian. You would thinkthat all veterinarians have this altruistic belief that pet welfare is everything.But veterinarians do place a mental cap on the value of the animal. If appropriatecare is going to cost a client more than $1,000, some veterinarians wonderif it is really worth it. And that preconceived value can be as low as $500.Well, if that veterinarian has that mindset, then he or she may not offermany options to the client. You may hear, 'There isn't much we can do. Thequality of life is poor; you should consider euthanasia.' The reality isyou are killing off your patient base."

Heinke says that veterinarians need to look for trends when trackingeuthanasias. "If you see practice mortuary costs increasing as a percentageof revenue, or euthanasia numbers increasing as a percentage of the totalpets seen for the year, or the percentage of returning clients dropping,they are all factors indicative of poor practice health."