A call to protest

Hattiesburg, Miss. — At least 35 veterinarians and 30 more family members recently converged on an area shelter to protest the loss of 40 percent of their spay-and-neuter business to a low-cost sterilization program.

The veterinarians sought to introduce a motion for the shelter to require proof of low income, says former shelter board member and organizer Dr. Kirk Frazier (third from left), a partner at All Animal Clinic in Hattiesburg.

The motion at the Southern Pines Animal Shelter Board of Directors membership meeting was not heard, but the veterinarians believe the move communicated a message.

"I can see where they were blindsided or surprised, but we kind of felt that was the only effective way to get the point across and be heard," says Frazier. "I understand they're not real interested in being fair. They're only interested in lowering the pet overpopulation problem. We are too; we want to look out for the pet's total health picture and make a living at it at the same time."

John Volk, a senior consultant with Brakke Consulting, says a recent study by his firm indicates that veterinarians across the nation are concerned about the effect that shelters and low-cost programs are having on their practices.

In a survey of veterinarians nationwide, the Bayer/Brakke Veterinary Care Usage Study found that practitioners cited an average of 15 competitors in their trade area. The majority of those (9.6) were traditional, independent veterinary clinics. Corporate practices (1.1), mobile vaccination clinics (1.0), pet store clinics (1.0), specialty referral clinics (1.4) and shelter veterinarians/low-cost services (1.2) made up the remainder.

While shelter programs and low-cost clinics do not represent the greatest competitive threat to most traditional veterinary practices, they represent the competition DVMs are most concerned about—moreso even than other independent veterinary practices, according to the study.

Low-cost, limited-service veterinary clinics ranked at the top of the list when it came to which competitors concerned veterinarians most at 20 percent, followed by 13 percent who say they are "very concerned" about competition from shelter veterinarians. Another 10 percent say they are most concerned about competition from other independent veterinary practices.

Broken promises?

Southern Pines Animal Shelter Spay and Neuter Clinic has been operating in Hattiesburg since the 1950s, says James Moore, vice president of the Southern Pines Animal Shelter Board of Directors, and opened its low-cost spay and neuter clinic in 2009.

The shelter clinic performed roughly 12,000 sterilizations for the community over the last two years, Moore says. The target is the underserved population of pet owners and pets, but its services are not limited to low-income individuals, he says.

"I would imagine that every vet has those clients in their customer base who can afford spay or neuter but don't spend their money on that," Moore says. Just because someone can afford sterilization, doesn't mean they want to spend their money on it, he adds. The shelter also targets "unmotivated" individuals by trying to entice them to sterilize their pets with the low-cost program.

"The problem, I think, that has really caused some friction is that (the shelter) does not restrict on income. We've had some of the vets' clients take advantage of our services," he says.

Moore explains that in addition to the low sterilization fees, the shelter clinic does not charge office visit fees or offer comprehensive diagnostics that are available through many traditional veterinary hospitals.

"We just provide efficient, assembly-line service," he says.

The shelter clinic offers sterilization from $35 for male cats to $70 for female dogs, but the price range drops to $17.50 to $37.50 with additional grant eligibility, according to the shelter's website.

In comparison, sterilization prices at veterinary practices around Hattiesburg range from $45 for male cats to $150 for large female dogs. Additional services such as intravenous fluids during surgery and additional blood work can increase these costs, Frazier says.

When the shelter first announced plans for its spay-and-neuter clinic, it promised that the service would be marketed to low-income residents and that veterinarians should expect only about 4 percent of their clients would use the service.

"Everyone was okay with that—a 4 percent loss of clients for the greater good of the community," Frazier says. "When the clinic opened, the message was different. It was 'come one; come all.'"

It's impossible for a private veterinarian to offer services competitively when a nonprofit shelter—that has the help of city and county subsidies, charitable grants and donations—can offer services for a fraction of the cost of most veterinary practices, he says.

"If you're competing for clients and you've got resources that aren't available to your competition, it's not fair," Frazier says.

The loss of business became evident in the second year of the shelter clinic's operations, he says. Veterinarians around Hattiesburg started seeing a much more significant percentage of their clients using the shelter's discounted services for spay-and-neuter procedures, he says.

"We see that it's roughly about 40 percent," Frazier says. That figure was reported by 35 veterinarians at 12 practices surrounding the shelter clinic, he adds.

Speaking up

Frazier says he tried to emphasize the role veterinarians could have at the shelter during the last year that he served on the shelter's board.

"Over a year of trying to show how important veterinarians are to a shelter by getting as many of us involved in providing problem-solving and material and services when asked; it felt like we subtly tried to make our feelings known and didn't feel like that was very effective," Frazier says. "Really, it felt like we weren't heard."

Veterinarians in the area felt like this was their only option, he says.

But the move blindsided the board, Moore says.

"The knee-jerk reaction from the shelter board was that veterinarians are trying to shut down the spay/neuter clinic. The concern is that the spay/neuter clinic is using resources intended for low-income community members that are being overused or abused by capable pet owners..." Frazier says. "When you get a chance to talk with people and explain it, they understand. If you donate $100 to a low-cost spay-and-neuter clinic, don't you want that to go to someone who needs it rather than someone who is able to take care of their pets?"

"On the surface, (it) sounds like a really reasonable request," Moore says of the motion made to restrict shelter clinic cases based on income. "But many of the middle income, low-motivation people would be excluded." While the shelter's ultimate goal is to reduce pet overpopulation, Moore argues that excluding a group of individuals from using its services would not allow the shelter to fulfill its mission. "And you can write that on the back of a T-shirt."

How do you distinguish which middle-class individuals need the clinic's services and which are abusing the system?

Frazier says veterinarians were upset with the resulting criticism in the community that they simply raised the motion to line their own pockets.

"It's not like we're just making money off the animals. There's a lot of help and goodwill that goes out to our patients and clients as well as our community," Frazier says. "We know that it is all well and good to say this is to reduce the pet overpopulation problem, and that's certainly a worthy goal, but veterinarians are in the business of taking care of animals, and they make their living doing that. We don't feel like we're the greedy money-grubbing business that sometimes we're made out to be. Any time the shelter asks us for help, they get it."

Frazier says the 12 veterinary practices around Hattiesburg estimate they have provided at least $400,000 in pro-bono services to the shelter and the community over the last year. And that's a conservative estimate, he adds.

"Our mission is to reduce euthanasia at our shelter," Moore contends. "We know that is done by increasing the spay/neuters in the community. I know the veterinarians' concern is about equity and a level playing field, but that's not our mission. I hope the vets appreciate the 3,000 new clients we create each year through adoptions at the shelter," Moore continues.

"I'd like to think that's worth more than one surgical procedure."

Working on a resolution

In the weeks that followed the mid-December meeting, Frazier says he has talked to some of the board members, and the two sides are forming a working committee between the shelter and area veterinarians to work out these issues.

But it could result in another stalemate.

"We get a lot of funding from various charities, some of which strictly prohibit means testing because the grantee wants us to reach that underserved or less motivated population," Moore says. "If we stop in mid-stream ... and we started not playing by the rules the grant was bestowed to us by, we would be in jeopardy of having to pay that grant back."

Frazier says he doesn't expect the board will go back and accept the veterinarians' motion and says it is not the intent of the veterinary community to force the shelter to go back on any previous agreements.

"I think the goal was to work around their contracts and try to aim more toward low-income targets," Frazier says, adding that a number of other shelters seem to be able to filter out abuse using a sliding income scale and fee system. That would allow the shelter to offer discounted services to middle-class clients, but at a more competitive rate, he adds.

Another concern the veterinarians hope to address is the possibility of the shelter opening a low-cost vaccination clinic. Frazier says the board was looking into a grant program to open such a clinic when he was a member. Moore referred questions about the program to the shelter's grant writer, who did not respond to DVM Newsmagazine.

"We heard this was just for low-income folks once before," Frazier says. "It's not about our business as the main thing. We just don't want to see the system abused at our expense."

"The veterinarian-client-patient relationship is probably the single most effective tool in animal health," Frazier says. "That relationship suffers when low-cost clinics give the impression that an animal has had all the care it will ever need or when a capable owner waits for the next charitable handout. Some health problems could be missed if they are going to low-cost clinics for vaccines or other health maintenance services."