I think it is safe to say that every veterinarian in the United States is simply exhausted. As a veterinary economist, I have had the unique pleasure to watch firsthand the significant stress and amount of work veterinarians are facing.
As essential workers, they are our first and only line of defense when it comes to animal health issues. Whether it is Sam my Scottish Terrier – who is currently dreaming of chasing something on the couch – or the livestock that will eventually end up being meat on someone’s dinner table, veterinarians play a vital role in our everyday lives. But since the COVID-19 pandemic started, veterinary clinics and hospitals have been overwhelmed to a point that they are turning away new clients and non-emergency cases. While I have listened to a lot of veterinarians talk about this regarding companion animals (dogs, cats, etc.), these issues are also affecting veterinarians in the food animal sector (dairy, beef, swine, poultry, etc.).
In the past few weeks there have been two different op-ed pieces in Pick the Brain and the New York Times about this unexpected side-effect of the pandemic. Within these articles there was quite a bit of discussion about the current state of the economy and how this might be affecting the sudden surge. There was also some mention of other economic concepts. But what I found interesting is that not one economist was consulted about the issue, much less a veterinary economist (there are more than just me!). So, this article is my attempt to provide a better economic perspective to the problem as well as my insights from recent conversations with veterinarians.
In the Pick the Brain article, 8 potential reasons are laid out as to the reason for the “perfect storm” of busyness: New patients in the market, reconnection to home, a shift in spending, time surplus, watching pets more closely, exposure to humans is dangerous, primary care backlog, and veterinary hospitals with limited staff/hours. The New York Times articles lists similar reasons but also notes that parvovirus cases have been on the rise for some clinics.
The discussion of ‘surges in animal adoptions and fostering’ seems to stem from data on pet adoptions and surrenders back in April. According to an article in the Associated Press and the New York Times, pet adoptions from shelters don’t actually seem to be up, but rather surrendering of pets is down. This is confirmed by the data from Shelter Animals Count. While there are still plenty of other outlets for people to adopt pets, the shelter data shows that adoptions and surrenders are down as much as half from last year, depending on the month. The most recent data from PetPoint also confirms this and notes that fostering is much higher in some states (+68% for dogs in Florida!). So, this may not be necessarily true that there are more pet owners or animals in the market.
There is definitely some truth to the ‘reconnection to home’ discussion. With this comes the unfortunate reality that we have no choice but to stare at our animal companions more than usual. Sam’s opinion (yes my dog ‘speaks’ to me, just through non-verbal communication…I’m not crazy…I think) is that I have paid much more attention to his needs for belly rubs and now desires even more. But the reality is we do notice the small changes in their behavior while also just noticing what they do all day while we used to be at work. This may mean that we are more dangerous for the reasons listed in the article. I have worked from home enough in my career, that Sam just continues his multiple naps whether I pay attention to him or not. As previously mentioned, there has been an increase in parvovirus cases and there have also been increases in pet poisonings from things like household cleaning supplies. So, it is reasonable to think that we are more dangerous for pets when we spend 24/7 with our animal companions.
This pandemic has shifted our spending patterns. The money we spend on food at home increased while food-away-from-home decreased. Food at home tends to be cheaper than ordering take out and many of us have found our desire to cook again (looking at all you sourdough bread bakers out there…). This means that there has been a major shift to saving our money. NOTE: INCREASED SAVING DOES NOT DIRECTLY MEAN WE ARE SPENDING MORE MONEY ELSEWHERE. The national savings rate has spiked to 33%, which means that the amount of money circulating in the economy has decreased. This does not mean we automatically shift our spending elsewhere. There was a slight overall decrease in pet supply spending so far this year. This was seems to have been due to a spike in spending in March and has dropped significantly and then levelled out. I would say that pet supplies are a sign that pet adoptions are not increasing.
The last reason I explored, in line with the other articles, is the limited staff/hours. There is a lot of variation in state level regulations on veterinary operations, and the need for additional precautionary procedures has limited the hours a clinic can operate. As the New York Times article notes, the time allotted to a ‘normal’ pet visit has been extended so less pets can be seen per day. In a recent conversation I was fortunate enough to be a part of with practicing veterinarians across the state of New York (among a few other places), many clinics stated that they simply did not have enough people working. They also noted that they all had to make significant changes to their operational procedures in order to accommodate contactless visits. When I spoke to an ambulatory vet who predominately works with dairy cows, she noted that she had also experienced additional hardships as some of her colleagues had to deal with increased at-home child care and some had fallen ill to the virus. This is supported by a recent survey conducted by the New York State Veterinary Medical Society that some areas are experiencing significantly reduced staff due to COVID-19 infections – only two-thirds were healthy and at work in the NYC metropolitan area.
According to VetSuccess, most clinics and hospitals are experiencing increases in year-over-year revenue. HOWEVER, the fact is that the number of invoices is down. This has huge implications as this means the increase in revenue is due to more expensive procedures and NOT because of an increase in overall demand (read: quantity). I encourage caution in thinking that demand in the economic sense is increasing. There is a definite increase on a veterinarian’s time, but this is likely due to additional procedural and operational time.
What Does all this Mean?
Now that we have a better, wholistic, view of what is going on from an economic perspective it is important to talk about what clinics should potentially be doing.
1. Enjoy the additional revenue coming into your business! This is a great thing but note that this is still expected to be temporary. You should be saving that additional revenue for a rainy day.
2. Wellness appointments for older (non-infant) pets – annual/semiannual checkups for vaccines and such – are not a priority right now and being pushed off far into the future. What message does this send to all the pet owners out there? The veterinary industry has spent years, if not decades, trying to convince pet owners to go to the vet regularly as its vital to the long-term health of the pet. And these annual visits created a recurring demand for veterinary services. But now they are not “necessary”? When the pandemic has ended, and the veterinary business is back to normal, consumers will not think that annual wellness checkups are necessary.
One solution is national guidance and PSAs about the need for wellness checkups, but that they can be delayed for a bit to help accommodate the increased emergency and urgent care needs. There needs to be organized and specific guidance on this issue from the AVMA or someone else.
3. With all this additional stress, there is a massive concern about veterinarian and veterinary technician burnout. According to the New York State Veterinary Medical Society survey, burnout was the top challenge clinics were facing. This will have implications in the short- and long-term for individual businesses and the whole industry. What are you doing to help combat burnout from an organizational perspective? Telling everyone to take time to meditate and find a ‘balance’ seems unrealistic when I’ve heard some clinics working (literally) 24 hours a day – with staff rotations of course – to keep up with the additional needs of the business.
4. What can we do to prevent these issues from happening in the future? The pessimistic side of me thinks that this is just the first of many crises to come. What all clinics need to do is assess their individual potential for excess capacity. In my conversations with other veterinary economists (Dr. Matt Salois and Dr. Mike Dicks), many clinics tend to employ only enough staff to handle the day-to-day operations. In addition, clinics are using every inch of space they have available to them. By building in additional resources to your business to handle times of operational demand, you can ensure that staff stress and burnout is reduced. I strongly encourage you to think about how you can do this given your current financial and physical status.
While I commend the various media outlets on their willingness and interest in covering issues related to veterinary medicine, it is important to look at the problem from as many perspectives as possible. I am not saying everything in this article is accurate. More information will come to light that may change everything I have to say about this topic. This is just my professional opinion as someone who has looked at the trends and talked to as many veterinarians as I could. The future of veterinary medicine is dependent on what we are doing now. What has happened during this pandemic in the past, and we must forge a bright future for the profession with our actions to serve our clients and our patients.
As always, thank you to all the new people who have connected with me and chatted with me about future collaborations and topics. This blog is all about communicating science based work that can impact people, businesses, and policy makers. Let’s make the world more informed with good science.
Interesting article, I especially like the point you make about the unintended consequences of not prioritizing wellness visits. However, I disagree with the recommendation to build excess capacity to handle future crisis. Another way to look at excess capacity is waste & inefficiency. The things good businesses are always trying to eliminate. Despite what all the doomsayers like to predict, there is a high probability that the coronavirus crisis we are experiencing today is probably a once-in-a-lifetime event. (The last pandemic was the Spanish Flu in 1918- over 100 year ago). Be careful not to let recency bias have too strong an influence on your business decisions.