The changing face of veterinary services

The Animal Care College – caring for people caring for animals

In theory there is no difference between theory and practice. In practice there is. Yogi Berra (One of the US’ greatest baseball players)

 
If you have never watched Gogglebox on Channel 4 you have missed a real treat.  Now on Series 8, the programme allows us to look into the lives of ten families and couples sitting comfortably in their living rooms and watching real television programmes during the previous week.  Sections of the programmes play and then we see and hear the comments being made by various families and groups.  You could be forgiven for thinking when you first watch it that it is scripted but you are actually eavesdropping on real viewers and the whole show gives credence to the hackneyed phrase ‘you couldn’t make it up’.  The whole show is clever as well as funny.  I won’t spoil it for you but I must tell you that the various reactions to the Crufts Best in Show were absolutely hilarious.  It is well worth watching each week and you can catch the Crufts episode by going to the Channel 4 website, signing up and searching for Googlebox, Series 7, Episode 5.

What I have found fascinating is that in the programme, dogs are central to this cross-section of family groups, partnerships and friends.  What is more, most of them are pedigree dogs and are generally seen curled up on the sofas with their owners’ arms around them.  It is a reflection of a point I have made on several occasions: that dogs are woven into the cultural fabric of our society and despite all the efforts of the anti-dog lobby this is more true now than perhaps it has ever been.  This is borne out in a recent article in The Times Magazine which highlighted how much we spend on our pets, dogs accounting for by far the highest expenditure.  The article was triggered partly by recent surveys by Petplan and Direct Line where one finding was that 54% of owners treasured their pets more than their partners!

Nearly half of all households in Britain own one or more pets, with more people owning dogs than cats (8.5 million: 7.4 million).  The accuracy of these figures cannot be guaranteed although it may be that the new requirement as of April 1st that all dogs should be microchipped will eventually give us a more realistic estimate of the number of dogs.  But we do know that it is in the millions and this is reflected in the increasing size of the ‘spend’ on pet ownership.  Pets At Home has reported an income of £729 million for the year ending March 2015 and that was a 10% increase on the previous year.

The Veterinary Marketing Association?

What is more, we are prepared to spend a great deal more in keeping our dogs alive as technology and techniques to do so have improved.  Although many thousands of dogs continue to have a role which supports the work or activities of their owners or handlers, the vast majority are no longer hunters, trackers, herders or guards.  They are pets and, as Nick Henderson, former President of the Veterinary Marketing Association (that very title tells you something in itself) and co-founder of the BSAVA said in 2010, ‘Pets have become surrogate children to thousands, possibly millions around the world, we can give thanks that this is the case since without such sentiments small animal practice would be a quiet place indeed’.

Since then things have moved forward rapidly partly due to the advances in veterinary science and surgery.  In some ways, Nick Henderson suggests, the clinic provides an outlet for owners to ‘express their true devotion’ and practices are more than happy to suggest tests and procedures which would have been impossible just a few years ago.  Conditions which would have resulted in a dog being put to sleep because further help was impossible until quite recently can now be treated very effectively although, it must be said, often very expensively.

Dippydoodah, a Staffordshire Bull Terrier, had a seizure and within days was under a general anaesthetic in an operating theatre having a brain tumour removed.  It was located with a state-of-the-art MRI scanner and two neurosurgeons, an anaesthetist and nurse were able to remove it before he returned home none the worse for his experience.  A year later, a further brain scan showed the tumour was starting to grow back again: this time it was suggested he should have targeted radiation therapy.  Almost every day for four weeks he had to be anaesthetised and held in the same position each day so that the specialist could deliver, in total, twenty high doses of radiation to the tumour.  Once again he returned home and is currently well.  The total cost?  £25,000!

Dippydoodah’s case is not unique and the veterinary community is happy to help.  Davies Veterinary Specialists based in Hertfordshire, has a staff of 170 and day-to-day procedures include open chest surgery, knee surgery, tumour removals and cataract surgery. It has six wards, three radiography suites, emergency blood analysis and an orthopaedic theatre which regularly replaces hips which cost anything up to £5000.  Although few breeders take out pet insurance many pet owners do and by next year premium income is expected to exceed £1 billion (compared with 853 million in 2014).  And premiums will continue to rise: in 2015, 911,000 claims were made – up 9% on the previous year.

James Herriot has become a distant memory

The veterinary world has changed a great deal in a few years not just in terms of the range of techniques and treatments that are now available but in its business model.  This may be because the number of female veterinary surgeons graduating from veterinary schools has been greater than males for many years but I understand that as standards of entry have risen most graduates whether male or female are, rightly, dedicated to serving the animals they treat rather than becoming a partner and running a business  The small, privately owned practice with one or two partners has virtually disappeared in favour of franchised veterinary groups which run as normal businesses employing veterinary surgeons, practice managers, veterinary nurses and veterinary receptionists as and when they are needed.  The U.K.’s top 100 veterinary businesses had a turnover in 2014 of £1.36 billion: it is speculative but entirely possible that the profit margin was greater than Pets at Home in its entirety!

The result has been a much more business orientated approach focusing on marketing, customer care, business plans, cost analysis benefits and the rest – James Herriot it isn’t!  Inevitably, there is a tendency to select more expensive treatments for clients rather the basic procedures in exactly the same way as your garage might ask, ‘Is it an insurance job?’ before working out your quote.

And people love their pets so geriatric veterinary medicine is a growth area.  It used to be that we could take sensible, thoughtful and loving decisions for our pets and kindly put them to sleep just before their life reached its natural ending.  That is no longer the case: modern pet owners want to keep their pets with them for as long as possible and they are prepared to pay for it.  When pets used to become seriously ill putting them to sleep was often the only option.  Now in an age of kidney transplants for  cats and chemotherapy for dogs, euthanasia has ‘begun to feel like a cruel way out’.

This provides an ethical dilemma for all those intelligent, animal-loving and skilled people upon whom we rely to make sure our animals are cared for properly when they are damaged or ill: should the lives of our pets be prolonged at all costs because that’s what our clients want (and will provide increasing profits) or should our role be to provide sensible, pragmatic advice which if followed will save clients’ money, relieve their stress and their pets’ pain and, perhaps by doing so, give another animal a loving home?

There is much discussion about these within the veterinary profession but as it becomes more and more business orientated the view on the ground will almost always be different from that expressed the ivory towers of veterinary academia.

PS: A recent visit to my own veterinary surgeon was interesting.  They are now part of a large group but sensibly charge £10 for micro chipping compared to others locally which range from £12 to £25.  My consultation fee seemed reasonable too so it does pay to ‘shop around’

 

 

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