Access to care is possibly the biggest animal welfare crisis affecting pets in the United States, said Dr. Zarah Hedge while in session on August 22nd. “Access to veterinary care: what do we know and where are we going?” At the AVMA Virtual Convention 2020.
Dr. Hedge is the chief medical officer and vice president of animal welfare medicine for the San Diego Humane Society.
Challenges related to access to care affect many areas of a community. However, there are ways to discuss incremental nursing and financial challenges with customers.
“We didn’t go to veterinary school because we wanted to go to the office and turn people away or euthanize animals for treatable conditions,” said Dr. Hedge. “This is taking a tremendous emotional toll on the veterinary profession. These ethical choices really take a toll on us. Wouldn’t it be great to create ways for these animals so they don’t have to be euthanized and given up? “
During the session, Dr. Hedge on what the profession can do to remove potential barriers to nursing.
Affordability is the biggest barrier to supply in the US. This is evident from the 2018 report “Access to Veterinary Care” of the University of Tennessee’s Program for Justice in Animal Health.
As previously reported by JAVMA News, the COVID-19 pandemic is likely to improve access to care as many people face financial challenges related to job losses (see JAVMA, July 1, 2020).
“We are facing the reality that this is likely to become an even bigger problem,” said Dr. Hedge. “We can no longer avoid this problem. We need to take meaningful steps to make changes. This is the human reality in which we live.
“Factors that caused this problem are not really the veterinary profession’s fault, but this is our problem to deal with and in reality we are not doing what needs to be done to address this problem. Ultimately, it takes a toll not only on these pets, families, and communities, but also on us as a profession. “
Talk about money
But how should vets talk to their clients about finances? Dr. Kate Boatright, a small animal veterinarian in Pennsylvania, spoke about how the spectrum of care is being received and discussed with customers during another session on Aug. 22 at the “Stories from the Trenches: Working Within Client’s Financial Limits” virtual session can.
Dr. Boatright said the first step is to define the standard of care.
“We should change our perspective a little. Instead of looking at the standard of care as a set baseline that is non-negotiable, let’s think of care as a spectrum, ”she said.
Dr. Boatright said when she gives customers a quote and they can’t afford it, she tinkers with it by reducing diagnostic tests and prioritizing patient comfort. She suggested asking questions like “Are you dealing with this complaint?” and “Are you satisfied with the possibilities as a doctor?”
Dr. Boatright suggests the following tips when working with incremental care:
- Assess the patient with a physical exam and obtain a full medical history from the client.
- Decide if testing is needed by asking questions such as “What information will be gained from the test and will my treatment change?”
- Always offer the customer the ideal care plan and then discuss the range of care when finances are an issue.
- Let a customer know what they’re giving up by doing incremental care.
- Express empathy for and understanding of the customer’s boundaries without judgment.
- Be transparent about costs and possible outcomes, but talk about care first, then talk about money.
- Ask questions like “What is your budget today?” and “What are your goals for today’s visit?”