President’s Message – Access to care: A critical consideration for you, your team, and our profession (November 2023 CVJ)

October 30, 2023

Access to care: A critical consideration for you, your team, and our profession

Have you thought about what it means for people or communities to have limited or no access to veterinary care? Have you thought about the role of our profession, and the obligations and responsibilities that come with being a member of the greatest profession on earth?

I remember a time in my early years in practice when colleagues began initiatives like the Chinook Project, to serve the remote communities of Northern Canada; or Vets Without Borders, which sought to build long-term solutions for underserved communities; or Community Veterinary Outreach, which focused on serving the underprivileged people and animals in our own biggest cities.

These were initiatives that garnered much respect for our profession. Indeed, they still do.

I remember feeling immense pride as I watched so many colleagues working for the benefit of society — perhaps with students in tow — in a genuine win-win-win for mentors, students, and underserved individuals and communities who were often disconnected from society and facing the kind of major human and animal welfare challenges that only a few of us can genuinely understand. I remember the early days of Community Veterinary Outreach, initiated to serve the innercity and homeless populations who owned pets, and the efforts expended to change the social narrative and recognize that pet ownership and the importance of the human-animal bond (and the directly connected human health outcomes) should not be a function of economic well-being or ability to pay.

The veterinary profession is unlike any other known to society; no other profession has the ability to cross so readily between animal well-being and human wellness. This truth is the underpinning of our collective responsibility to serve and the underpinning for our profession’s historically high respect within society.

It is often said that “respect is not given, it is earned.” In 2013, veterinarians ranked 7th among the most respected professions; and in 2022, our profession ranked 12th. This is not a reflection of us as individuals, but we should not ignore that societal views have shifted, and we should each spend time reflecting on what has led to this change.

Historically, we have almost entirely framed our understanding of “access to care” based on geographic extremes or economic disadvantage. This may have been largely true in the past, but we are now at a crossroad where, again, the reality has shifted and access to care is no longer solely a challenge in our historical context.

There have been many recent discussions among leaders in our profession and media reports about the increasingly challenging economic conditions that are making access to care a much more real mainstream problem. This, coupled with the fact that many practices are facing challenges in providing service owing to staffing challenges and barriers left over from the COVID-19 pandemic, is contributing to the very real risk of our profession falling short in serving society at large.

I am not alone in my increasing concern, as access to care has become a frequent topic of discussion at meetings, here at home and abroad. This discussion has been top-of-mind at our own recent CVMA convention, as well as at recent Canadian Animal Health Institute (CAHI), American Veterinary Medical Association (AVMA), and Federation of Veterinarians of Europe (FVE) meetings, where attendees and speakers highlighted both serious risks to our profession and underlying challenges in providing service to our communities (and not strictly the most remote ones). Several media reports over the last year have emphasized the cost of veterinary care and the difficultly in accessing care as significant factors leading to increased surrender rates in a post pandemic world that is financially stressed owing to the greatest inflation pressure in over 30 years.

Our profession faces many challenges, but I believe we are absolutely up to the task of meeting them. In the coming days and months, we will all need to find ways to limit the price pressures in veterinary medicine and find ways to break down the remnants of pandemic barriers to access and provide a spectrum of care appropriate to patient and owner needs. Remember, there is no “gold standard,” only access and good medicine appropriate to the situation you face.

Each of us will have a role to play, as will each of our team members. The challenge for each of us will be to look inward and ask our teams, “What does good look like?” and to engage them in developing solutions at home that will better improve access to care for the society we serve.

“We must not, in trying to think about how we can make a big difference, ignore small daily differences we can make which, over time, add up to big differences that we often cannot foresee.”

Marian Wright Edelman,
Children’s Rights Activist

Dr. Trevor Lawson