Cost of Care, Access to Care, and Payment Options in Veterinary Practice.

Accessing veterinary care is increasingly challenging for US pet families. Although there are many contributing factors, the cost of care presents the greatest challenge. This article explores the ways in which payment options, a spectrum of care approach, and the stratification of care might improve access to care.

The Economics of Small Animal Veterinary Practice.

Recent economic cycles and unique factors like the COVID-19 pandemic have all affected small animal veterinary practice, changing both demand and supply-side factors. One-time events exacerbated cyclical macroeconomic factors, increasing the highs and worsening the lows. Behind the perceived labor shortage, the mental health concerns, and the challenges of staff turnover in the profession's daily work to meet client expectations and provide the best possible medical care lurks a productivity problem. The good news is that veterinary practices can take steps to improve productivity and resilience in the face of these challenging trends.

Building Value for Veterinary Practice Sale.

This article provides an overview of the factors that lead to veterinary practice value. People do not enter veterinary medicine with the primary goals of owning and operating a small business. However, those who spend their careers in private practice may start or purchase a veterinary practice. To maximize value, the business must be profitable and carry as little risk to a potential buyer as possible. This article discusses the adjustments a professional valuation analyst is likely to make to calculate profits, the elements that measure risk, and how to mitigate that risk to increase value.

What are the risks of clinic-backed payment plans?

The purpose of this viewpoint is to discuss the risks associated with offering clinic-backed payment plans, with a particular focus on financial risks. We provide a financial calculator tool that clinics can use with their financial information to make more informed decisions about whether implementing clinic-backed payment plans are viable for them. Realistic but hypothetical financial information for a clinic is used to simulate financial evaluations, including cash flow budget analysis, multivariate sensitivity analysis, and risk assessment to help clinics better understand these evaluations. Our simulations show that even under high default rates, the revenue benefits outweigh the labor costs and could bring higher profitability to clinics while increasing access to care for clients and patients.

Veterinary Practice Profitability: You Have to Measure It to Manage It.

There are many actions a practice can take to improve its profitability but the management team must first know what the profitability of the practice actually is. Fortunately, there are multiple resources available to practice owners and managers to get this information. Understanding not only the profitability of the practice but the kinds of factors that lead to this state is critical. Until the practice has an idea of the root causes of the problem, it is difficult to determine what the correct solution is. Fortunately, there are also many resources available to help a practice change and improve.

11 years of regular access to subsidized veterinary services is associated with improved dog health and welfare in remote northern communities.

Access to veterinary services can have positive impacts on animal health and welfare, and on human mental and physical health and well-being; however, many communities worldwide lack access to such services. At their request, the 5 communities of the Sahtu Settlement Area, Northwest Territories, Canada, have received annual access to preventive veterinary services through the University of Calgary's Northern Community Health Rotation since 2008. To determine the reach of the program, we conducted a dog census in 2017. We then conducted a chart review of 11 years of dog medical records from 2008 to 2018 to evaluate how the reach of the program, the uptake of veterinary services, and dog population demographics, health and welfare measures changed over the duration of the program. In the chart review, we used either multi-level logistic regression or generalized linear models, to determine how seven variables, including age, sex, breed, body condition, deworming, vaccination, and sterilization status upon clinic entry, changed over the course of program delivery. Our results suggest that program reach, veterinary service uptake, and dog demographic, health and welfare measures improved over time. We observed high rabies vaccination coverage in some communities (48 %-83 % of the dog population) and moderate overall sterilization status (25 %-56 % of the dog population) with female dog sterilization more common than male (75 % of dogs leaving the 2017 clinics, compared to 43 %). Several dog demographic, health, and welfare measures, including age, body condition, and vaccination, deworming, and sterilization status, were significantly better in later years of the program (all p < 0.001). Differences among communities, both in dog population numbers from the 2017 census (40-89 dogs) and in the uptake of veterinary services in 2017 (48 %-83 % of the dog population), were notable. Vaccination uptake was directly related to clinic attendance, but sterilization was impacted by additional factors, including community members' acceptance of the procedure. Some unintended consequences were noted, however, including the potential effect of sterilization on the availability of traditional dog breeds in the communities. Overall, our study findings demonstrate that subsidized veterinary services provided over a regular and extended period of time benefit animal population demographics, health and welfare, and could have positive impacts on human well-being. The framework of community collaboration and long-term commitment developed through this program serves as a model for achieving common health goals among communities in need and veterinary service providers.

Estimating antimicrobial usage based on sales to beef and dairy farms from UK veterinary practices.

BACKGROUND: Accurate estimation of antimicrobial use (AMU) is important in assessing reduction of agricultural AMU. This cross-sectional study aimed to evaluate several approaches for estimating AMU at the herd level and to report on AMU for beef and dairy farms in Scotland. METHODS: Pharmaceutical sales data for 75 cattle herds (2011-2015) were screened for antimicrobial products and aggregated by herd and year. Several denominators for usage estimates were calculated and compared for their suitability at the herd level. RESULTS: The median total mass of active ingredient sold per kg of bovine livestock was 9.5 mg/kg for beef herds and 14.3 mg/kg for dairy herds. The 'highest priority critically important' antimicrobials (HPCIA) were by total mass of active ingredient, 10.6% of all sales; by total defined daily dose veterinary (DDDVet), 29.8% and by DCDvet, 20.0%. These are the first estimates of AMU for beef cattle in the UK, and for cattle of any kind in Scotland. Estimates of herd-level usage based on population correction unit (PCU) were sensitive to low values for PCU for specific herd-years due to their demographic composition. CONCLUSION: Pharmaceutical sales data can provide useful estimates of AMU, but estimating usage per PCU is not appropriate for comparing groups of cattle with different demographic compositions or for setting herd-level targets. Total mass of active ingredient per kilogram of livestock is more stable and hence suitable than PCU-based methods for assessing AMU at the herd level.

Evaluating farm-level livestock interventions in low-income countries: a scoping review of what works, how, and why.

Livestock interventions can improve nutrition, health, and economic well-being of communities. The objectives of this review were to identify and characterize livestock interventions in developing countries and to assess their effectiveness in achieving development outcomes. A scoping review, guided by a search strategy, was conducted. Papers needed to be written in English, published in peer-reviewed journals, and describe interventions in animal health and production. Out of 2739 publications systematically screened at the title, abstract, and full publication levels, 70 met our inclusion criteria and were considered in the study. Eight relatively high-quality papers were identified and added, resulting in 78 reviewed publications. Only 15 studies used randomized controlled trial designs making it possible to confidently link interventions with the resulting outcomes. Eight studies had human nutrition or health as outcomes, 11 focused on disease control, and four were on livestock production. Eight interventions were considered successful, but only four were scalable. We found good evidence that livestock-transfer programs, leveraging livestock products for nutrition, and helping farmers manage priority diseases, can improve human well-being. Our report highlights challenges in garnering evidence for livestock interventions in developing countries and provides suggestions on how to improve the quantity and quality of future evaluations.

Farmers' and veterinary surgeons' knowledge, perceptions and attitudes towards cattle abortion investigations in the UK.

BACKGROUND: Cattle abortion can significantly affect farm productivity and be an important cause of economic loss on beef and dairy farms. METHOD: A questionnaire-based survey, completed by 379 farmers and 134 veterinary surgeons from the UK and Ireland, investigated motivators and barriers towards abortion investigations and perceptions of cattle abortion. Participants were recruited using convenience sampling. RESULTS: Veterinary surgeons underestimated farmers' willingness to pay for an abortion investigation; 54 per cent of veterinary surgeons expected farmers to pay under 100£/€, compared with 46 per cent of farmers. Most farmers (27 per cent) were willing to pay 101-250£/€ and 12 per cent above 500£/€. The incidence threshold warranting abortion investigation was 4 per cent for veterinary surgeons and lower for farmers at 2 per cent, especially beef farmers, where 48 per cent indicated a 1 per cent incidence required attention. Seventy-five per cent of dairy farmers used more than 2 per cent as their threshold. Eighty-four per cent of veterinary surgeons and 95 per cent of farmers agreed on the same abortion definition. CONCLUSION: Veterinary surgeons and farmers agree on the definition of abortion; however, veterinary surgeons underestimate the willingness of farmers to engage with and pay for abortion investigations. A more proactive approach from veterinary surgeons, including improved communication and transparency around costs, expectations and clients' goals can improve abortion investigation outcomes.

Access to veterinary services and expenditure on pig health management: the case of smallholder pig farmers in Northern Uganda.

Pig farming has gained momentum for most smallholder farmers in developing countries as a means of livelihood and household incomes. However, prospects of the pig enterprises are constrained by pig health management issues which affect both its productivity and profitability. Using a cross-sectional survey of 240 smallholder pig farmers, we assessed factors influencing farmers' access to veterinary services and expenditure on pig health management in northern Uganda. Data was analysed using the binary logit and censored tobit regression models. Access to veterinary services was significantly influenced by pig herd size (p < 0.05), Village Savings and Loan Association (VSLA) membership (p < 0.1), breed (p < 0.05), production system (p < 0.05) and number of health issues recorded on farm (p < 0.01). Education level (p < 0.01), farming household members (p < 0.05), pig herd size (p < 0.01), breed (p < 0.05), previous disease incidences (p < 0.05), household labour available (p < 0.1) and access to veterinary services (p < 0.01) significantly influenced pig health expenditure. Efforts to improve access to veterinary services and improve pig health management should focus on promoting more intensive production systems and improved breeds that are associated with better access to veterinary services and reduced cost of pig health management.

Online procurement of pet supplies and willingness to pay for veterinary telemedicine.

Changing consumer shopping behaviors, and specifically the shift towards online procurement of goods and services, have altered the retail landscape of nearly all goods, including pet products and services. Whilst it is known and commonly discussed that less retail business for products and medications is being conducted in clinics than in the past, it is not well documented where that commerce is now taking place, and by what customer segments. For cats, dogs, and other pets, specialty food and food in general was purchased by a high percentage of respondents at the physical store. Sixteen-percent of dog owners, 17 % of cat owners and 14 % of other animal owners purchased prescription food at the veterinarian. Ten percent of dog owners, 10 % of cat owners, and 9 % of other animal owners purchased prescription food from the physical store. A high percentage of cat and dog owners purchased flea and tick preventative, heartworm preventative and prescription medications at the veterinarian, followed by the physical store. Using a choice experiment, both dog and cat owners were willing-to-pay a statistically significant positive amount for having their veterinarian, or a veterinarian in their community (who was not their veterinarian) on the veterinary telemedicine call or video when compared to a veterinarian from outside the community. In relation to the willingness to pay (WTP) for a telemedicine veterinary consultation with a veterinarian outside of the pet owners' community, dog owners were willing to pay $38.04 more for a telemedicine veterinary consultation with their regular veterinarian, and $13.38 more for a telemedicine veterinary consultation with a veterinarian in the dog owners' community. Cat owners had a WTP of $38.12 per call or visit for having their veterinarian as the consultant which was statistically higher than their WTP for a veterinarian in their community, $12.74 when compared to a veterinarian outside their community. When comparing the mean price adjusted WTP between cat and dog owners, there were not any statistically significant differences found. Quantifying pet owner willingness to pay for commonly discussed attributes of telemedicine, such as whether a local veterinarian is consulted (versus a veterinarian from outside the community), facilitates veterinary practice management decision making as practices adjust product and service offerings to meet the changing consumer demand of pet owners in today's marketplace.