An epic healthcare crisis is crushing the veterinary system – Santa Monica Daily Press

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Los Angeles is in the midst of an unprecedented health care crisis. Routine treatment has been delayed, emergency rooms are turning patients away, staffing shortages are crippling the system, and there is a weeks-long waiting list for vaccines. It’s a crisis brought on by the Covid-19 pandemic but it’s wreaking havoc on pet rather than human populations.
Fundamentally there are just too many pets and not enough vets to care for them but the particular details are threefold.
“There’s a staffing shortage, both at a technical level and a doctor level and I certainly would call that a crisis,” said ACCESS Specialty Animal Hospitals Director of Operations Leah Basinais. “There is an influx of new pet owners which in and of itself, fantastic. We love pet owners in this industry, right? But, at the same time, you don’t have the capacity to care for it. Because of the staffing shortages. There is a veterinary suicide component to this that I think is a huge crisis.”
The stats vary based on the data point being tracked but all signs point towards massive pet adoption in the past two years.
More than 11 million pets were adopted from March to November of 2020, internet traffic for pet adoption increased 250% in 2020, adoptions from shelters increased by 12 percent in the last year and shelters were literally empty.
Madeline Bernstein, President of the Society for the Prevention of Cruelty to Animals Los Angeles, said owning a pet was a way of socializing that didn’t otherwise exist in lockdown.
“So not only was the animal company, if you were confined to lockdown by yourself you couldn’t go to work. We’re working at home, but you could go to dog parks, you could walk, you see other pet owners.”
Whether the new pets came from a shelter or breeder, they were likely in a location where a single vet could treat multiple patients. Animals that may have received centralized care in a shelter are now in individual homes. While that’s great for their emotional wellbeing and long-term health, it means those pets now require individual appointments for their care, whether it be emergency appointments or routine care.
At the same time, there has also been an influx of animals into the system. As the pandemic progressed, there was more opportunity to breed animals due to people staying home and losing other work. Unscrupulous brokers have also increased the quantity of animals imported which is disproportionately damaging to the system as pets that have been rushed into the economy are often sicker than animals sourced from ethical practices.
“People are so anxious to become part of this ‘I got a dog too during the pandemic’ that they’re trying to bring in dogs from other places that have other diseases that are not going to be well,” said Bernstein. “They’re desperately going to need veterinary help and they’re not able to get it and just with a little adult patience, they could just wait a little longer and not have their dog or not get their dog on the day they decide to get a dog, but maybe wait a few weeks and work with a shelter as the population changes.”
While a huge number of new pets would stress a functional system, veterinary care was far from healthy prior to the pandemic with significant staff shortages.
“But the staffing shortages used to be exclusively doctor in nature,” said Basinais. “We couldn’t get enough doctors and now you know, but we’ve got the support staff. It’s transitioned to be both doctor shortages and paraprofessional staff shortages. And I think that’s sort of a function of COVID but it also has to do with the educational opportunities, the money that’s in the industry, not being as prevalent for technical staff. So I think it’s a lot of different factors that go into it, but certainly staffing shortages have only been exacerbated by COVID.”
The combined impact of high demand and low supply in the vet business has an entirely predictable and tragic impact.
Bernstein said a friend recently had an emergency and was turned away from several clinics.
“She was in literally an extreme emergency situation, and she literally waited outside in the car, so that they could come out if a dog died and they suddenly had time they would come out and get whoever was next in the car. This is emergency service. It’s grim.”
Bernstein’s friend eventually found care far from their usual locations and her situation is now close to the norm.
“Unfortunately, six to eight hour wait times are not unusual,” added Basinais, “and occasions when our emergency rooms reach full capacity and are unable to accept new patients are more frequent. And it’s not just our hospitals — we often get phone calls from desperate pet owners telling us we are the fifth hospital they called and that no one could take them.”
Bernstein likened the problem to the shipping fiasco just offshore.
“It’s almost like the ports right, there’s gridlock in terms of getting veterinary care or appointments or regular wellness visits. Just like with people, if it’s not life threatening or an emergency, if you just need a routine checkup you’re going to be scheduled months out.”
The system of triage, while vital to saving pets in the moment, may have its own exacerbating effect on the system and Los Angeles has already seen increases in two preventable dog diseases. Pets who are unable to get preventative care or treatment for routine aliments may become the very emergencies that are currently clogging the pipeline. The situation also increases the likelihood of viral outbreaks as vaccines that were previously easy to obtain now take weeks to secure.
Bernstein has no shortage of ideas for solutions, although she says none of them are without problems. You could import vets from other states (but those states also have shortages), loosen admission requirements at schools (but that is a years-long wait) or increase services by technicians (who are already overburdened and underpaid). There are also problems with the distribution of the vets that do exist with more severe shortages in rural communities and perpetual difficulty finding vets who can work in shelters while trying to pay off large education debts.
She said some solutions could come from regulatory changes that would allow shelters to administer more routine care, establish a new class of regulated professional below a full vet who could operate like a nurse practitioner and ease rules regarding drug transportation to allow more mobile vets into the system.
Bernstein said there’s a glimmer of hope in telemedicine for pets. She said the rules were eased during the pandemic to allow for some expansion of those services but the long-term prognosis for that part of the industry is unclear.
“Some of the more stringent restrictions on telemedicine involving pets were suspended during the pandemic. So they made that a little bit easier … I don’t know how long that will last.”
Basinais said part of the solution is to bring more people into the industry. She said wages need to match the demand but that the staffing shortage is so profound, there are jobs open at almost every position.
“So if people recognize ‘I don’t have to be a vet to work in that hospital,’ there are plenty of jobs available to people who have no experience whatsoever across the country. I think that we can actually kind of help solve some of our own problems, by taking jobs and getting involved in veterinary work.”
However, she said pet owners are also part of the solution because while some accidents are unavoidable, many patients are coming into clinics with preventable issues.
“I think so many people don’t know that this is a real problem and that these are issues that the veterinary community is facing and it’s not just our problem. It’s our problem that affects you, the owner, greatly and so I can’t tell you how many times I see owners coming in for things that are 100% totally avoidable. And, you know, it’s frustrating for me, I can only imagine how frustrating it is for them. And so for me, it’s the education component of owners who have an incredible opportunity to keep their pets safe.”
She said owners need to do what is best for their pet’s health, not what is necessarily the most fun. Animals without a leash are vastly more likely to have a serious accident and homes need to be secured for a pet much like they do for a child.
“I can’t tell you how many cases we have every day where an owner comes in because the pet got into their stash of drugs or something inappropriate that they shouldn’t have. They didn’t put the lid on the trash can and the dog got some GI indiscretion from eating the entire contents of the trash can. There’s so many of those that if those were not part of the normal daily influx of patients, it would very favorably impact the ability to care for the others.”
The situation is also dangerous for the practitioners themselves. Vets are between two and three times more likely to committee suicide and one in six have contemplated taking their own life.
Basinais said the profession attracts a highly empathetic population who have deep emotional connections to animal welfare. However, their daily experience is a constant stream of animals in distress and frequently death. That takes its toll as does the interaction with individuals who are emotionally distraught over their pet’s health.
According to Basinais, accusations of price gouging are common and deeply hurtful to individuals who may be paying off debts themselves.
“And so when you have this very empathetic population of people that are working in particularly a private practice that has to make money in order to stay open and continue to do business, there’s always this sort of ‘you’re in it for the money feeling’ that gets projected onto veterinary staff. I think that, compounded by the type of personality, the fact that veterinary services are pretty expensive, you can’t do it for free. And that, owners, we know they want to care for them, and if they can’t afford it, it becomes very upsetting, right?”
She said there’s no obvious light at the end of the tunnel but simple kindness and patience are appreciated.
“We know these times can be frustrating, and we ask for your understanding as we navigate our increased demand and other changes that have reshaped the way we operate, such as closed lobbies and increased safety protocols,” says Basinais. “We are all in this together, and at the end of the day, we are here doing our best trying to help you and your pets.”
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