Who is Limited Access to Veterinary Care Hurting?

When a family member we care about suddenly experiences a sickness or injury, we as caregivers have the urge to jump into action and bring an end to their discomfort. For some of us, this could mean calling the pediatrician at odd hours to ask if a single cough warrants a trip to the ER, or nagging our partner until they finally go to the chiropractor about that back spasm. For others, it could mean calling the local animal shelter to surrender their family pet because treating the issue at hand is cost-prohibitive.   

The common denominator in these three cases is that the caregiver simply wants their loved one to get the care they need. The outlier is that one of these families doesn’t have the resources to make it happen.

While many people have no access to health insurance, struggle to get to a doctor, or have high insurance deductibles, there is still a relatively accessible social safety net to support their health needs, especially those of children. But what about the health needs of our non-human family members, the ones that provide companionship and emotional comfort to more than half of all households?

What about our pets?

Access to veterinary care is a growing topic of concern among veterinary professionals, and for good reason. Access to veterinary care not only impacts pets, but also their caregivers, animal care professionals, and our communities.

According to the ASPCA, one of the leaders in access to veterinary care, “access to veterinary care means owned dogs and cats universally and equitably receive care that improves their welfare, decreases suffering, and is compassionate, respectful, and considerate of pets and family circumstances.”

 

A 2018 survey by the Access to Veterinary Care Coalition found that 28% of pet owners experienced a barrier to care in the last two years, and 23% were unable to provide preventive care for at least one of their pets. Furthermore, according to Pets for Life data, approximately 17 million pets in underserved communities have never seen a veterinarian. This is not even taking into consideration the explosion of veterinary care that was needed during and following the COVID-19 pandemic.

With the growing need for accessible veterinary care, more programs and education resources are being developed to help lessen the barrier gap.

Access to veterinary care is not only an issue among families from lower socioeconomic backgrounds. It is impacted by the availability of services, which can be a serious issue for families of all income levels living in rural areas with limited providers, as well as families without transportation and those that can manage preventive care but not emergency costs.

That said, the 2018 Access to Veterinary Care Report conducted by the Access to Veterinary Care Coalition found that financial constraints were indeed the number one reason people did not seek veterinary care, had to surrender their pet, or selected euthanasia.

Before getting into these programs and educational resources, and developing an action plan, we need to understand why they matter. Limited access to veterinary care not only impacts those families that are seeking care, but also has a ripple effect on care providers and communities as well.

 

Impact on bonded families

As of 2023, 66% of households have pets, versus roughly 40% of households that have children. Of those households with pets, 97% consider their four-legged friends to be family members. Millennials currently make up the largest pet-owning population. Given the many emotional and physical benefits the human-animal bond provides, it’s not surprising that pet ownership is on the rise. Specifically, these benefits include:

• Companionship and social support
• Increase in oxytocin (the “feel good” hormone)
• Decrease in cortisol (the stress hormone)
• Lower blood pressure and reduced risk of stroke
• Increase in physical activity
• Increase in sense of purpose and self-efficacy
• Enhanced coping skills
• Reduced feelings of loneliness

Given these benefits, it is understandable that families are seriously impacted when they are unable to give their beloved pets the veterinary care they need.

Shame, guilt, frustration, grief and anger – pet owners experience a range of emotions when they are in crisis mode due to a need not being met. Sadly, when they turn these emotions inward, they impact their mental health. And when they turn these emotions outward, as they often do, they impact the relationships they have with those they were counting on for support.

While there is limited research that captures the emotional toll of being unable to provide a pet with necessary care, vets have hundreds of thousands of stories that demonstrate the impact.

Personally, I have seen many a pet owner heartbroken over being unable to pay for medical treatment that would alleviate their pet’s discomfort. The sense of guilt and pain that a family experiences is real and has a lasting impact. Many end up working with therapists to process the guilt and trauma of having to euthanize their non-human family member because they can neither afford the care nor stand to watch them suffer. This trauma carries over into other aspects of their lives and interactions with future animal care providers. It can manifest into mistrust, or prompt them to delay seeking care in the future because of shame or in an effort to avoid heartache.

 

Impact on animal care professionals

With the increase in homes with pets and the decrease in animal care providers, there are not enough service providers and feasible health care options for pets that need medical attention. This stress on the veterinary community is not going unnoticed. The veterinary community is under a great deal of stress and for a number of reasons. Among them, access to veterinary care.

When financial constraints prevent a veterinary team member from providing the care they know will end their patient’s discomfort or suffering, they experience what is known as moral distress. Moral distress is “the psychological distress of being constrained from being able to act on what one knows to be right” (Andrew Jameton, Nursing Practices: The Ethical Issues). In short, animal care professionals experience negative emotional stress when they are not able to do what they took an oath to do, which is care for the animal in need.

Veterinarians have little control over the rising costs of veterinary care and even if they do, they still have to earn a living for themselves, and run a business that enables them to effectively support other families. While it may go unnoticed, veterinarians are deeply affected when families come in needing care but are unable to afford it. Long exposure to moral distress can lead to compassion fatigue, burnout, and secondary trauma. These are the burdens veterinary professionals carry with them when they cannot support a family.

According to the Merck Veterinary Wellbeing Study, the percentage of veterinary professionals suffering from serious psychological distress has increased since 2019. Other studies have shown that veterinarians are 1.6 to 2.4 times and veterinary technicians 2.3 to 5 times more likely than the general public to die by suicide.

 

   

Impact on the greater community

The final pillar that is impacted by limited access to veterinary care is the community as a whole. As mentioned earlier, when a family is not able to access care, they may surrender the pet to an animal welfare organization. This can lead to an overcrowded shelter system, moral distress and compassion fatigue among animal welfare professionals, and more monetary implications for the shelter system. 

To make matters worse, communities with greater barriers to veterinary care are likely to have more animals that have foregone important health care treatments, including preventative care. This, in turn, means an increased risk of zoonotic diseases in these communities. This all puts enormous pressure on members of our communities, and when individuals suffer, we suffer as a whole.  

The worse access to veterinary care gets, the more we need to raise awareness, share stories, and educate the public at large in order to facilitate change.

 

   

Planning for the unknown

Some say if you cannot afford a pet, you should not have one. And while this may have a ring of truth to it, the same could be said for children. Pets and their health can be unpredictable and while parents think they can manage the financial aspects, various life events can alter their life and ability to afford certain things. Yet, we as a society continue to have children and pets because the benefits outweigh everything else. As a society we have made adjustments to support those children who are in need, just as we will continue to do for pets.

Pet owners faced with challenges beyond their control should not be denied the benefits of the human-animal bond. After all, for some, this is the only bond they will ever experience.

From statistics, research and personal stories about families experiencing limited access to veterinary care, we are finding that many families are able to manage their pets’ day-to-day care, i.e., food, water, shelter. However, they're financially unprepared for unforeseen accidents and illnesses. This makes sense, given about 65% of working Americans say they are living paycheck to paycheck (The Harris Poll).

While there is certainly a national need for better human and non-human support, there are some small steps pet owners can take to better prepare for the unexpected.

• Invest in pet insurance. Much like human insurance, pet insurance can ease the financial burden of preventive care, emergency care, and follow-up care. There are a number of pet insurances available at different price points.
• Ask about payment options. Many vets work with companies like CareCredit to provide financing options.
• Set aside a small amount each month. Even if it is only $10 or $20,  it could end up being the down payment for essential services in your pet’s time of need.
• Locate preventative clinics in your area. Knowing when vaccine clinics or wellness clinics for your pet are happening could help you avoid escalated medical ailments.
• There are often different levels of care, talk with your vet team to find the right fit for your family and budget. Get pet health insurance, a small investment monthly can make a big difference when your pet gets ill.

Resources

While access to veterinary care is a nationwide issue, with a number of different components that need to be addressed to make change there are steps families can take to support each other. Pet owners should be encouraged and educated about responsible care for their non-human family members. Often this falls on animal welfare organizations, shelters, breeders, and veterinary offices. Hopefully the information shared above, as well as links to resources below, will help make planning for the unknown a little less scary. 

• First Aid Tips for Pet Owners
• Overview of Pet Insurance
• Pets for Life Program
• Compassion Animal Project
• Pet Owner Education and Tools 

For Veterinary Providers: Not One More Vet

Citations

Access to veterinary care resources. ASPCApro. (2023, September 13). https://www.aspcapro.org/access-veterinary-care-resources

Maddie’s Fund. (2018). (rep.). Access to Veterinary Care. Retrieved 2024, from https://pphe.utk.edu/wp-content/uploads/2020/09/avcc-report.pdf.

Luhmann, Maike & Kalitzki, Anna. (2016). How Animals Contribute to Subjective Well-Being: A Comprehensive Model of Protective and Risk Factors. The Journal of Positive Psychology. in press. 10.1080/17439760.2016.1257054. .

Luhman & Kalitzki, 2018; Kabel & Teti, 2015

Krittanawong et al, 2020

Krittanawong C, Virk HUH, Bangalore S, Wang Z, Johnson KW, Pinotti R, Zhang H, Kaplin S, Narasimhan B, Kitai T, Baber U, Halperin JL, Tang WHW. Machine learning prediction in cardiovascular diseases: a meta-analysis. Sci Rep. 2020 Sep 29;10(1):16057. doi: 10.1038/s41598-020-72685-1. PMID: 32994452; PMCID: PMC7525515.

Summers, J. W. (1985). [Review of NURSING PRACTICE: THE ETHICAL ISSUES, by A. Jameton]. Business & Professional Ethics Journal, 4(1), 83–87. http://www.jstor.org/stable/27799853

Brown, A. (2023, July 7). About half of U.S. pet owners say their pets are as much a part of their family as a human member. Pew Research Center. https://www.pewresearch.org/short-reads/2023/07/07/about-half-us-of-pet-owners-say-their-pets-are-as-much-a-part-of-their-family-as-a-human-member/

Nett, R. J., Witte, T. K., Holzbauer, S. M., Elchos, B. L., Campagnolo, E. R., Musgrave, K. J., Carter, K. K., Kurkjian, K. M., Vanicek, C. F., O’Leary, D. R., Pride, K. R. & Funk, R. H. (2015). Risk factors for suicide, attitudes toward mental illness, and practice-related stressors among US veterinarians. Journal of the American Veterinary Medical Association, 247(8),945-955. https://doi.org/10.2460/javma.247.8.945