The paradox of preventive care
We should celebrate the state of nothingness. The absence of illness is a consequence of frequent visits and client compliance.
Preventive care benefits pets, people, providers and practices.
One of the many challenges our society faces with COVID-19 is that nothing happens if we wear a mask, wash our hands, and physically move away from each other. Nothing is a good thing, right? No one gets sick. However, it is difficult to recognize and reinforce behavior that results in the absence of disease.
The same goes for preventive care in veterinary medicine. When we see a pet at least twice a year, give advice on nutrition, behavior and dental care, and meet parasite and vaccination needs, nothing happens. There are no dramatic hero moments to celebrate. Sounds like the premise of “Seinfeld,” the on-nothing TV show yet considered by many to be the greatest sitcom of all time.
Intervention against the disease is relatively easy. It can generally be seen, experienced and valued. The presence of a tumor versus the absence of one. An itchy animal compared to a comfortable animal. Pretty obvious.
The absence of disease, on the other hand, is not so obvious. When was the last time a client walked into the exam room and congratulated you on their pet’s freedom from distemper, obesity, or heartworm disease?
Our entire medical system (human and veterinary) is built on a model of reactive care. Responding to pathological states versus strengthening a state of health. React and repair versus prevent and prepare.
Stop the drama
The pandemic has reinforced the value of preventive care for veterinary professionals. We have postponed nonessential preventive care, although I would say very little is nonessential in veterinary practice. We then dealt with the predictable rise in parvo, pyometra, Lyme disease and more. Doctors, dentists and optometrists have seen similar consequences downstream of delaying preventive care.
Financial incentives favor illness more than welfare. Reactive care results in a high single financial transaction compared to the low single financial transaction of preventive care.
It can be argued that comprehensive preventive care leads to a reduction in emergency medicine. Considering the huge increase in emergency needs related to COVID and the resulting stress for our colleagues in emergency care, this seems like a good thing.
We heroize the reactive and the dramatic to the detriment of preventive care. Let’s stop the drama and make the absence of disease the hero. Celebrate health and make the invisible visible. Praise pet owners for their great care.
Well-being breeds well-being
The welfare of a professional veterinarian benefits from better preventative care for pets. How? ‘Or’ What? We improve the well-being of veterinary professionals by limiting dramatic, unbudgeted, traumatic and reactive events. Instead of the demanding reactive care for wellness, there is relationship building, client education and bonding that takes place through routine preventive care. Deep human bonds, trusting relationships and friendships result from multiple interactions in preventive care. Well-being translates into the well-being of pets, their owners and veterinary teams.
Economic euthanasia, shortened lifespans of pets, suffering, crisis interactions and stressful discussions with clients all impact veterinary professionals. Pets, pet owners and providers all benefit from good preventative pet care. Oh, and did I mention that these animals live longer and happier lives?
Room for optimism
If I sound too pessimistic, don’t get me wrong. I remain optimistic about veterinary medicine. The number of pets is up, pet spending is up, the lifespan of pets is up, euthanasia is down, shelters are emptying and we remain among the professionals. most respected in society. We have a lot to celebrate.
However, the welfare issues among veterinary professionals are real. I submit that a commitment to preventative pet care will reduce stress, burnout and compassion fatigue. By decreasing the number of dramatic urgent cases and through good client education and preventive care, we improve our well-being.
It might just be me, but I’d rather see a routine date with a healthy pet involving a long-time client that my team and I have built a deep, trusting relationship with rather than seeing a case. urgent with an uncertain prognosis presented by a client whom I rarely see and often complicated by financial constraints. I smile a lot more often in the first scenario.
Spins against winnings
For preventive care to be adopted, the current model must be challenged. The old one-visit, one-doctor and once-a-year model will no longer hold up for veterinary teams, clients and patients. A 20-minute annual appointment is not enough to educate clients about nutrition, behavior, dental care, vaccinations, and parasites. We need more contact with clients in person or virtually, either by the doctor or by a member of the team. Ideally, three or four interactions per year are needed to better educate pet owners, build trust, improve communication, and foster adherence to necessary preventative care.
For some of us, this requires a fundamental change in our approach to practice. I would argue that we have taken a ‘paid’ approach to veterinary medicine when the ‘turns’ are much better suited. What do I mean? According to a VetSuccess study, one-year patient visits (rounds) are more strongly correlated with practice revenue than the most commonly used single client transaction (wins). Research suggests that customers are more sensitive to the cost of a single visit than to the amount spent over a year.
Lower costs per visit resulted in more visits. More visits are more strongly correlated with higher income per patient. More visits, in person or online and with a doctor or veterinarian nurse, results in better educated clients and better pet care. Spins are more important than wins.
Lifespan of pets
Recall the American Animal Hospital Association study from several years ago in which the lifetime value of an animal receiving all the recommended care over a 12-year lifespan resulted in an expense of $ 17,700 . This compares to the average AAHA accredited hospital which provides only $ 3,600. It’s almost a five-fold difference.
The lifespan of pets has increased dramatically over the past few decades, largely due to preventative care. Cats typically live 12 to 15 years and dogs 10 to 13 years old, but what is their biological potential? How old would cats and dogs live if adherence to preventive care approached 100%? I suspect we would see 20 year old cats and teenage dogs on a regular basis.
Imagine the benefits to society if the lifespan of our beloved pets increases by 50%. What is the benefit of an additional three, four or five years of life for pets, their owners and our profession? It is immeasurable. The $ 17,700 per pet would be well over $ 20,000 and possibly closer to $ 30,000. Preventive care benefits pets, people, providers and practices.
Our profession is essential to the well-being of society. We can do a better job, however, by embracing preventive care. “Seinfeld” made a huge success out of thin air. How to make prevention a success?
Creative Disruption columnist Dr Bob Lester is the Chief Medical Officer of WellHaven Pet Health, a former practice owner and a founding member of Banfield Pet Hospital and Lincoln Memorial University College of Veterinary Medicine. He serves on the boards of directors of Pet Peace of Mind, WellHaven Pet Health and Lincoln Memorial Veterinary University. He is vice president of the North American Veterinary Community.
The WellHaven Pet Health family of practices have found that subscription wellness plans are remarkably effective in providing needed preventative care. Welfare plans support animal care budgeting and encourage more visits.