The Future of Veterinary Care: What Will It Hold?

Kim Campbell Thornton

There’s a popular belief that the Chinese word for crisis is composed of two characters, one symbolizing danger, the other opportunity. While linguists argue that the interpretation is erroneous, there’s no denying that change brought about by crisis can certainly open doors to new opportunities.

Veterinary medicine, while commonly thought of as a conservative profession, is frequently in flux, no more so than right now. And it’s not just because of the COVID-19 pandemic. The maturation of the millennials, those who are veterinarians and those who are pet lovers, has also brought change to the field.

“The shift in generations as millennials enter their most influential years is a significant driver of change and innovation,” says Drew Weigner, DVM, president of Winn Feline Foundation. “The gradual decline in birth and marriage rates means pets often substitute for children. These trends were in evidence for many years but have only accelerated as millennials mature.”

Other changes he notes are a potential decrease in vaccination rates if more pets remain indoors, increased spending on higher quality pet supplies, and the growth of shelter medicine as a specialty, to name just a few.

“Demand for behavior consulting may increase, not just for small miscreants, but as a component of environmental enrichment,” he says. “Advances in oncology, antiviral therapy, stem therapy—these are all areas we are actively engaged in.”

None of those things are really unexpected, though. The advent of COVID-19 and the changes it has brought to veterinary medicine in a breathtakingly short period of time is more of a surprise.

A Change in the World

In fewer than 80 days, veterinary medicine has been turned on its head. In March, as if directed by twilight bark, pigeon post, or maybe Hogwarts owls, veterinary clinics across the country began alerting clients to park, call, and wait in the car while their pets were taken in for exams by masked and gloved vet techs.

“To see how quickly they were able to develop new programs and protocols in the face of social distancing was really quite impressive,” says Peter Weinstein, DVM, executive director of the Southern California Veterinary Medical Association. One Oakland, California, veterinarian he spoke to in early March was already offering a sort of valet drop-off service at her clinic on a busy street.

Telehealth, social media, and video content of pets being cared for “in the back” are rapidly becoming the norm in more and more clinics. Those communication and delivery elements of veterinary care were gradually being accepted—in a field with a reputation for being slow to effect change—but their use has escalated dramatically.

These accommodations, made in the face of massive societal shutdowns to slow the spread of COVID-19, are likely to continue to be a part of veterinary business models going forward. Dr. Weinstein believes they will become the norm.

Changes to veterinary medicine were already in the works before the novel coronavirus came along to change everyone’s lives, but those changes have been accelerated to a breadth and depth unimaginable to anyone who has been involved with veterinary medicine for many decades, says Marty Becker, DVM, founder of Fear Free Pets.  “Pre-COVID, we were already seeing veterinary practices focus on the emotional wellbeing of pets, embrace people waiting in their vehicles, giving pets the choice of where they were examined, and a much greater focus on treating pain,” he says. “COVID gave veterinary practices a big shove to utilize telemedicine, embrace remote check-in, make sure every pet’s emotional wellbeing was at the forefront, how to squeeze more efficiencies out of the hospital team and a major focus on the emotional wellbeing of the practice team.”

Pet parents are experiencing a range of emotions. Some are fine with letting pets go in on their own. They are the ones who’d rather not see needlesticks or blood and are happy to pick up  pets after vaccination or treatment. Some don’t love it but understand and embrace the safety aspect. And there are those who fight it tooth and nail and want to be there for everything, Weinstein says.

Practices that utilized strong communication skills and let clients know what to expect clearly and succinctly, maybe with videos, probably got less pushback than practices that failed to clearly explain what to expect, he says.

“I think those practices with much more accepting clients fully explained it, and if the clients weren’t happy with the concept, they probably sought a second opinion, only to find out that everybody’s pretty much doing it the same way.”

It could be a trial run for a rollout of much more explicit email or snail mail instructions for clients before they bring pets in, whether it’s the first visit or the fiftieth. It’s a renewed opportunity to explain procedures for Fear Free visits and exams, how they enhance physical safety and emotional wellbeing for humans and animals, and offer the option for pre-visit pharmaceuticals.

Virtual Visits

As far as being there for the exam, that previously wasn’t always possible anyway for busy owners. Even pre-COVID, some people dropped pets off in the morning and picked them up after the exam, relying on a phone call or quick in-person meeting with the veterinarian to get a report on their pet’s health. But now many have been able to participate via Zoom, Skype, or FaceTime so they can see the exam in real time, ask and answer questions, and be assured that their pet is being handled with care. Even if they can’t “attend” the exam that way, they may still be able to view a video of it later.

“I think that’s a huge value add and will probably decrease the number of back-and-forth questions and answers that happen when you just go over it over the phone,” Weinstein says.

True telemedicine, or telehealth, is still a work in progress but COVID-19 could result in a more rapid transition to its use.

“If society in general becomes more insular and less mobile, pets will be vital for companionship and emotional support,” Dr. Weigner says. “It’s also likely telemedicine, already popular with humans, will be expected for pets, and veterinary visits may decline.”

Telehealth has a number of components, such as the owner calling to ask if a pet needs to be brought in based on information shared in the phone call; consultations between veterinarians, specialists, and owners; or follow-up care for an existing condition with an existing client.

Whether veterinarians can offer diagnoses and treatment plans based on, say, a Zoom exam varies from state to state. And they may be unable to do so unless they already have an established relationship with a client. That is one element of care that is still changing slowly but it may become more common if some owners remain concerned about the risks of viral exposure.

Some states allow veterinarians to establish a new veterinarian-client-patient relationship virtually; in others, veterinarians are working toward it. Members of the Veterinary Virtual Care Association seek to improve the ability of veterinarians to provide a variety of virtual services using digital or remote tools to diagnose and treat animals.

Issues being wrestled with include safely handling healthcare or emergencies for pets whose owners are in quarantine and no valid VCPR exists as well as the types of advice that can be given to existing clients.

For clients and pets in rural areas or who have little access to transportation, the change could enable or improve their access to care. Some visits could be done through FaceTime with video or photo imaging. Even clients who live nearby and don’t have transportation difficulties could benefit from being able to send a video of a pet’s gait, respiration, or other behavior that might not be repeated in the exam room.

“I think there’s a wonderful opportunity to embrace telemedicine if the regulatory bodies in your state or in your province allow you to do so,” says Jonathan Bloom, DVM, a partner at Willowdale Animal Hospital in Toronto.

For Dr. Bloom, the changes have also been an opportunity to continue to build relationships with and educate clients—not only about their pets’ health but also potential signs of illness in themselves. During appointment reminder calls, receptionists can ask if clients are showing signs of fever or illness, shortness of breath, or coughing, or if they have recently traveled to high-risk areas. It’s also a good time to remind them to bring a mask if they’ll be entering the clinic.

Communicating Hidden Things

It’s also an opportunity for veterinary hospitals to communicate policies and procedures in place to ensure safety of humans and animals. Veterinary clinics take lots of precautions that people may never see—or smell. Every part of a veterinary hospital, from the lobby to the exam rooms to the surgery, is designed to be disinfected. “You’re not going to see plush fabrics that harbor pathogens,” says Julie Reck, DVM, owner of Veterinary Medical Center of Fort Mill in South Carolina. “We’re also communicating key details about how sophisticated our disinfectants are. We like to use the Rescue line of disinfectant because it doesn’t leave a lingering chemical smell and its accelerated hydrogen peroxide technology is bactericidal, virucidal, and fungicidal.”

With permission, Dr. Reck sometimes uses social media to allay concerns of clients who can’t be with their pets. Staff members may post patient photos or updates on social media so clients can see how their animals are doing after an exam or surgery.

What Stays? What Goes?

Of course, not all changes will be permanent, and no one would want them to be. Kathryn Primm, DVM, owner and chief veterinarian at Applebrook Animal Hospital in Ooltewah, Tennessee, has been examining pets in a covered area outdoors. With warmer weather, she’s ready to get back to her indoor exam rooms, but she has also seen benefits from the outdoor exam area.

“I was able to diagnose a neurological issue on a dog that had always laid down immediately when anyone tried to look at him,” she says. “In our backyard, he was happy to walk around us, and I could observe him freely. Without the social-distance guidelines, I am not sure I would have started my exam outside, so it’s a good thing for him.”

Dr. Primm expects to continue offering curbside service as an option for pharmaceutical pickups, for instance, but she believes face time is important for clients and veterinarians and that pets prefer to be with their people during exams. Fortunately, patients have been, well, patient with the unusual visits.

“We have been reaping the rewards of our Fear Free methods because pets are almost all willing to come with my team into the building,” she says.

Human fears may take longer to subside.

“There’s a psychological aspect and a fear aspect that will continue to haunt us,” Dr. Bloom says. “So there will probably be some hybrid models going forward.”

There’s no doubt the COVID crisis will lead to changes in the profession, some permanent, some probably not. At this point, it’s still unclear what it will look like in a year, let alone well into the future.

“New things like curbside service and not letting owners into hospitals will have to fit into whatever the world looks like when things settle down,” says Tony Johnson, DVM, DACVIM. “So many changes were already happening—the rise of specialization, the change in gender balance [80 percent of new grads are female], the student debt load crisis, and the rise of big companies buying mom and pop vet clinics. Now we have to see what the crisis leaves us with. It was definitely a shock and will change the face of how we practice.”

What we do know is that advances in veterinary medicine are continuing to increase pet lifespans. And shelter medicine as a specialty means that more pets will survive to thrive in homes. The position of pets as members of the family continues unabated.

Embracing and implementing some of these changes can entail risk, but the rewards—for veterinarians, pet parents, and pets—can be well worth it. Because what’s not going to change is the power of the human-animal bond.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Kim Campbell Thornton is content manager for Fear Free Pets and is a Level 3 Fear Free Certified Professional. She has been writing about dogs, cats, wildlife, and marine life since 1985 and is a recipient of multiple awards from the Cat Writers Association, Dog Writers Association of America, and American Society of Journalists and Authors. When she’s not writing or editing, she’s competing in nose work trials with Harper and Keeper, her Cavalier King Charles Spaniels.

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