Designing Prevention
When Heart + Paw was founded in 2018 by Dr. George Melillo, the vision was clear: build a veterinary and pet care organization that supports not only pets and clients, but also the professionals providing care.
“We’ve focused not just on low-stress care for pets and clients, but also for veterinary professionals,” said Chief Veterinary Officer Dr. Mary Peacock. “When we think about how we design our hospitals, implement tools and lead teams, it’s all centered on minimizing friction points for veterinary staff.”
Heart + Paw has leaned heavily into technology, developing its own client portal, app and online booking platform to streamline the client experience and reduce administrative strain. At the same time, the organization maintains a strong operational framework while giving hospitals meaningful autonomy. Directors of operations — all veterinarians — support no more than 10 hospitals each, allowing for deeper relationships and consistent medical oversight.
That balance of structure and flexibility carries into parasite prevention strategy. Rather than mandating a single protocol, Heart + Paw empowers individual hospitals teams to choose plans that best fit their communities.
“We don’t dictate a single parasite prevention protocol across all hospitals,” Dr. Peacock explained. “Each team chooses the parasite control plan (or parasite prevention strategy) that best fits their community and patient population.”
Teams will emphasize parasiticides that best meet the individual needs of the pet based on their lifestyle and household dynamic. According to Dr. Peacock, belief drives results. “When teams believe in the plans they’re recommending — rather than being told what to stock — their recommendations are stronger and clients feel that confidence.”
High-performing hospitals also ensure parasite prevention is a team-wide priority. “It’s about having a strong, unified point of view and ensuring everyone can confidently speak to it,” Dr. Peacock said — from veterinarians to client service representatives.
The cost conversation
As conversations about rising veterinary costs enter mainstream media, practices are increasingly navigating how affordability influences preventive compliance. For Heart + Paw, the solution lies in a mix of transparency and flexibility.
“Pet owners generally want to do the best for their pets,” said Dr. Peacock. “Compliance improves when the care team believes in the recommendations and clearly communicates value — while also offering financial options.”
Heart + Paw emphasizes individualized care plans that map out predictable preventive services over a 12-month period. By outlining annual wellness needs in advance, clients can better anticipate and budget for care. The organization separates preventives from its care plans, allowing clients to take advantage of online pharmacy savings and autoship programs. That distinction, Dr. Peacock noted, reduces financial friction and supports year-round adherence.
“Expecting clients to come into the hospital repeatedly to purchase preventives can be a barrier,” she explained. “Online pharmacy partnerships help remove that obstacle.”
Education also plays a pivotal role in shifting pet owners from seasonal to year-round prevention. Dr. Peacock said receptivity increases when clients understand the risks — particularly if they have experienced conditions such as flea allergic dermatitis firsthand. But education cannot be limited to the exam room.
Practices should leverage email, social media and client portals, while sharing resources from organizations such as American Veterinary Medical Association, Companion Animal Parasite Council and American Animal Hospital Association to reinforce consistent messaging.
Newer parasiticides — including injectables and extended-duration products — have further reshaped compliance strategies. By understanding purchasing history and client behavior, teams can tailor recommendations to real-world habits. “If we know a client is only buying six months of prevention, that becomes an important conversation,” Dr. Peacock said.
The value of the wellness appointment
As the conversation turns to long-term success in preventive care, Dr. Peacock points to one foundational element: the wellness appointment itself.
“How practices structure and value wellness appointments makes a significant difference,” Peacock said.
At Heart + Paw, that belief is reflected in a commitment to 30-minute default appointments. Rather than treating wellness visits as routine or transactional, the organization views them as intentional touchpoints — dedicated time to strengthen the veterinarian-client relationship and set a clear preventive roadmap for the year ahead.
“Wellness visits shouldn’t feel rushed or like a ‘catch-up’ visit,” Dr. Peacock explained. “They should be intentional, thorough touchpoints focused on connecting with the client, understanding the patient’s needs and setting preventive goals for the year ahead.”
That structure reinforces every other compliance strategy discussed — from individualized care plans and online pharmacy partnerships to year-round parasite prevention and data-informed recommendations. When teams are given adequate time, they can educate, answer questions, address financial concerns and tailor recommendations to each patient’s lifestyle and risk profile.
Ultimately, Dr. Peacock believes prevention is not just about product selection or protocol design; it is about the experience practices create. “When wellness appointments are structured thoughtfully and given adequate time, compliance and client relationships improve,” she said. “That commitment to prevention has to be reflected in how we design the appointment experience.”
For Heart + Paw Chief Veterinary Officer Dr. Mary Peacock, the most valuable vendor partnerships go beyond free samples. While samples have a place, she notes they can shift conversations toward price instead of value.
The greater opportunity lies in expanding access — increasing the percentage of pets receiving any effective preventive. Representatives who engage practices in reviewing compliance data, such as take-home rates and autoship participation, and collaborate on strategies to improve those numbers become true partners.
The biggest untapped market? Pets currently receiving no parasite prevention at all.
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