Читать книгу Pet-Specific Care for the Veterinary Team - Группа авторов - Страница 162

Veterinarians cite financial considerations in veterinary medicine to be the principal wellspring of stress and burnout. Whether overburdened by student loan debt, bullied by suppliers or overwhelmed by clients who cannot afford to treat their unwell pets, the veterinary profession clearly has a vested interest in addressing the affordability issues that keep pet owners from caring for their pets as they would like to.

To that end, the veterinary industry has devised some strategies to help pet owners overcome their inability to pay for veterinary services, including pet health insurance (see 10.16 Pet Health Insurance), payment (wellness) plans (see 10.17 Payment and Wellness Plans), and third‐party financing (see 10.18 Financing Veterinary Care). Other options include nonprofit and for‐profit programs for low‐income clientele, limited‐service veterinary care (e.g., vaccine clinics), publicly funded veterinary clinics, and shelter medicine programs (see 10.14 Providing Cost‐Effective Care for Those in Need).

Despite these earnest attempts to address the profession's incipient affordability crisis, the veterinary profession has as yet failed to achieve a sustainable solution. Meanwhile, the divide between the “haves” and “have nots” expands exponentially with no signs of moderating any time in the near future.

The following is a list of considerations devised to mitigate costs and address other affordability concerns.

 Create and standardize tiers of care based on acceptable alternatives, allowing for a variety of standards of care (see 7.8 Providing Care for Those Unable or Unwilling to Pay). In this scenario, for example, a level one, minimal care standard could be considered ethical and legally defensible for financially stressed households.

 Create a system by which individuals may be “income qualified” for lower cost services, thereby assessing affordability concerns more objectively. This qualification could provide a more practical, verifiable route for justification of a minimal standard of care.

 Provide practical instruction for students at veterinary teaching hospitals to address affordability issues by advancing a breadth of diagnostic and treatment options. This may serve to address stigma surrounding reduced standards of care so that all practices, including secondary and tertiary care practices, can more readily offer a wider variety of care options (see 2.2 The Role of Incremental Care).

 Provide practice management consultation services to low‐income practices and promote the concept of for‐profit community clinics to veterinarians with shelter medicine interests or public service leanings.

 Establish not‐for‐profit payment plan services to help those with low credit scores to finance care.

 Negotiate more aggressively with veterinary pharmaceutical companies to provide lower cost drugs and products to prequalified low‐income pet owners or in shelter settings.

 Only in very specific situations will discounting be a suitable solution (see 2.11 Discounting in Veterinary Practice)

 Support and promote shelter medicine and public policy programs in veterinary schools. Establish tuition reimbursement programs for students willing to practice in low‐income settings to help address these candidates' unique financial concerns.

The veterinary profession is clearly at a crossroads in its search for a meaningful, sustainable solution to this emerging crisis. The profession is undeniably well equipped with the creativity and compassion to overcome this critical issue before it affects future generations adversely, but it will need to confront it honestly and meaningfully at the highest levels of the veterinary establishment to do so. The profession is currently engaged in the early stages of exploration of this complex issue.