How animal medicine went corporate

When I was a child, I went through a phase where I desperately wanted to be a veterinarian. I read all the works of James Herriot (the inspiration for many an actual working veterinarian), and I was obsessed with the idea of helping animals. Although I didn’t pursue that particular dream, my love of animals endures, and so does my interest in the veterinary profession — not least because I’ve always had cats, and cats tend to need veterinary attention periodically, sometimes extremely complex veterinary attention.

I’ve always visited small practices, sometimes with just one or two vets. In part that’s because in a rural area, that’s all there is. My current vet is a general practitioner who can provide a variety of basic services, and she brings in a locum for more complicated things, like specialized surgeries. Some veterinary services, like MRI and advanced medical imaging, chemotherapy, radiation, organ transplants, and the like aren’t available here because there aren’t enough patients to support them.

The fact that these services are available at all is kind of amazing — in the last decade, the veterinary industry has expanded tremendously, with a growth in specializations and accompanying medical interventions. Not that long ago, if you had an animal in kidney failure, your options were pretty limited. Now, you can get a variety of things up to and including a transplant — for a price. This reflects the fact that domestic animals have become members of the family, and we want more medical options for them, while livestock in some cases are extremely valuable, making investments in veterinary care worth it. When horses cost millions of dollars, you don’t shrug at a medical issue and hope it works out. When a cow is the genetic foundation of your herd, you don’t take her out back and shoot her if she’s not feeling well.

In some senses, I think this is good. People should have options, and our enhanced understanding of animal health is a net good. In others, I think it can work against us — because there is a law of diminishing returns for anyone when it comes to medical care. Humans can make informed choices about which treatments they want and how to pursue them — in most cases — but animals cannot, and furthermore don’t understand what’s happening to them. The demand for more things means that there’s a corresponding pressure to do all the things even if it’s not really the right choice, because who would be so monstrous as to not pursue every option?

The growth in available treatments has also given birth to the rise of the corporate veterinary clinic, part of a chain of facilities owned by a distant third party that attempts to profit from high patient turnover and the aggressive pursuit of clinical care. I’m not knocking vets and technicians who work for chain hospitals. A lot of them do really great work, genuinely care about animals, and offer the best advice and care they can for their patients. They don’t view their patients as walking cash registers and focus instead on providing the best care they can offer because they believe it is the right thing to do.

But the companies behind them in many ways remind me of major human hospital and clinic chains, which are also growing in number. Veterinary chains, like Banfield and VCA, are consolidating into massive conglomerates that span the nation. Much like chain hospitals, they have the resources to choke out small practitioners, putting them in a terrible position. They can’t reduce prices because they can’t absorb the loss, and so clients leave for a cheaper clinic. They can’t expand the services they offer because they don’t have the resources, so clients again depart for a clinic that provides them.

Sympathy for the solo practitioner or small, independent practice isn’t just about thinking that people should be able to practice medicine in a way that works for them. It’s also about the fact that steamrollering competition really hurts patients in the long run, because corporate care isn’t always the best choice, and sometimes it comes with hidden costs. ‘Insurance’ plans that are actually loans, for example, or pressure to turn appointments over quickly, which leads to rushing and poor decisions as people struggle to get through as many patients as they can. Denial of services also becomes a big issue; if a corporate vet refuses to work with you, where do you go?

And some of the things small, independent practices offer aren’t available on the corporate level. Like the vet who cuts a client a break because they’re obviously struggling to pay to care for an animal they care about very much. The clinic that puts in volunteer resources to help local animal rescues, and collaborates with shelters with things like a well pet voucher program — our Humane Society, for example, gives out a certificate for a free first visit to adopters to encourage them to pick a vet and establish a relationship. Yes, many corporations try to work on similar programs, but they can be limited and depersonalised.

Consolidation that has effectively wiped out mom and pops has shown up in another place: The funeral industry, which actually pioneered the tactics used by the medical industry. Major funeral chains like SCI don’t just own the homes, but maintain a vertical monopoly. They own the casket company, the florist, the monument carving facility, and more. Everything goes through them and that means customers lose out, because they don’t get competitive prices and they often get very impersonalised, generic, conveyer belt treatment. This is what I see happening in the human health industry, and it worries me to see it in the veterinary industry — that a few chains have seen there’s money to be made as pet guardians are willing to spend more, and consequently, they’re changing the face of the industry for profit.

Image: At the Vet’s, Anne Worner, Flickr