Access to Veterinary Care: A National Family Crisis

Missouri Veterinary Medical Association Conference January 10, 2021

Michael J. Blackwell, DVM, MPH

Access to Veterinary Care: A National Family Crisis

Pets have become an integral part of our families. Before the COVID-19 pandemic, an estimated 29 million dogs and cats lived in families participating in the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps. Qualifying for SNAP indicates limited ability to pay for veterinary care. The pandemic has likely increased the number of pet owners who need assistance.

The Access to Veterinary Care Coalition's report, Access to Veterinary Care: Barriers, Current Practices, and Public Policy, released in December 2018, presents findings from a national study to understand better the barriers to veterinary care experienced by pet owners across the socioeconomic spectrum. More than one out of four pet owners (28%) reported having experienced a barrier to veterinary care, overwhelmingly due to a lack of adequate funds.

We face a paradox: it may be logical that someone should not have a pet if they cannot provide veterinary care, yet denying companionship with pets is difficult to defend. Veterinarians take an oath to use their professional knowledge and skills to benefit society which spans the socioeconomic spectrum.

A One Health healthcare system is critical to improving access to veterinary care. Such a system reflects an understanding that barriers to veterinary care are human factors, primarily associated with low socioeconomics, and that veterinarians alone cannot fix the problem. In this One Health healthcare system, veterinarians understand they provide healthcare to families by focusing on non-human members (i.e., pets). Thus, veterinary services integrate with human healthcare and family support programs.

AlignCare is a novel One Health healthcare system that enables veterinarians to serve families who otherwise would not receive veterinary care. Historically, veterinarians have sought to control costs for those with limited means by not doing all they desire for the patient. Some level of care is better than no care and helps safeguard the quality of life, avoiding not helping or euthanizing the patient. This incremental veterinary care (IVC) is a tiered and dynamic approach to patient management within limited available financial and other resources. The practitioner exercises science-based judgment regarding which patient needs are most critical. IVC helps to control costs, thus keeping pets with their family. Families who qualify for AlignCare participate in a means-tested public assistance program. They are required to pay a copayment. Veterinary service providers offer discounted services and agree to work with a third-party payer, i.e., AlignCare. As a system, AlignCare includes veterinary social workers, human support coordinators, and partnering social service agencies, animal welfare organizations, and funders.

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Companion Animal

Karen Campbell-Motsinger, DVM, MS, DACVD, DACVIM

University of Missouri Satellite Specialty Clinic Wentzville, MO

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