Affordability, Communication and the Vet–Client Disconnect

Veterinary care in the U.S. is facing a complex set of challenges: rising costs, client expectations and the emotional and financial pressures on clinic teams.

Vet-Advantage spoke with Aimee Gilbreath, president of PetSmart Charities, about the PetSmart Charities–Gallup State of Pet Care Study: Veterinarians’ Perspective on American Veterinary Care, which sheds light on a disconnect between veterinarians and pet owners. The study explores how differences in perception, training and communication can affect care decisions — and how practices can use tools like payment plans, informed conversations, and a spectrum-of-care approach to better meet client needs, support pets and reduce stress in the veterinary workforce.

Before we get into the study findings, tell us a little bit about PetSmart Charities. What are some of your key initiatives and organizational goals? What should people know about the work you do?

Aimee Gilbreath: We have the privilege of being the largest grantmaker in our space in North America, thanks to the incredible generosity of PetSmart customers who donate while they shop. We provide grants in Canada from the money raised in Canadian stores, and in the U.S. from the money raised in U.S. stores.

Many people know us for our in-store adoptions, our legacy program. This year, we’ll host over 2,500 animal welfare organizations in PetSmart stores, facilitating about 400,000 adoptions — and over 11 million adoptions to date. This program is the most visible part of our work.

Nearly 20 years ago, PetSmart Charities began addressing access to care, funding the startup of high-quality, high-volume spay/neuter clinics and supporting research on topics like pediatric spay/neuter. As needs have evolved, we’ve shifted toward “Lifetime Care,” focusing on community primary care and developing sustainable models through nonprofit partners. We also fund research — recently on payment plans and studies comparing two-dose versus three-dose heartworm treatment protocols — and conduct industry convenings, such as the Gallup research.

Beyond veterinary care, we address pet hunger, helping get pet food into human food banks. Families experiencing food insecurity often struggle to feed their pets, so we partner with organizations like Feeding America and Meals on Wheels America. We also work in disaster response, collaborating with the American Red Cross to ensure shelters are pet-friendly and supporting pets as integral members of the family.

I truly believe we have the best jobs ever. It’s an incredible privilege to take donor dollars — most of which come in small amounts, $2 or $3 at a time — and turn them into meaningful programs that benefit pets and their families. We take that responsibility very seriously.

One thing that stood out in the PetSmart Charities–Gallup State of Pet Care Study was a perceived disconnect between veterinarians and pet owners. Did you see that as well? Why do you think there’s such a gap in how each side views the vet-client relationship?

Gilbreath: Yes — and it’s fascinating. In fact, there’s only one place in the two surveys where veterinarians and pet parents are clearly aligned: affordability. Both groups identified cost as the biggest issue, which at least gives us some common ground.

Beyond that, the perspectives really diverge. Veterinarians often report that when affordability is a concern, they offer options or payment plans. But far fewer pet parents say they were actually offered a more affordable option or a payment plan. Surveys are a bit of a blunt instrument, so they don’t capture every nuance, but other data from the veterinary survey helped us develop a working theory.

I believe veterinarians are generally comfortable offering options — up to a point — but not necessarily across the full spectrum of medically viable care. Many pet parents, for financial or other reasons, need an option somewhere on that broader spectrum that isn’t always being presented. So, a veterinarian may say, accurately, “I offered option A and option B,” but if option B is still financially out of reach, the pet parent doesn’t feel they were given a viable choice.

It almost sounds like these are conversations veterinary practices need to have internally — before the pet parent even arrives — about the spectrum of care. Why is there discomfort? Why aren’t veterinarians comfortable offering care across the full spectrum?

Gilbreath: The data gives some hints. Part of it comes from how veterinarians were trained in school. For a while, veterinary education leaned heavily toward tertiary, specialist-driven care. If you’re in a teaching hospital observing the most advanced, high-tech, expensive treatments, that becomes “the right way” to practice. Many veterinarians told us in the survey that they try to align with that training. About a third said they find it distressing to practice below what they call the “gold standard,” though that phrase is falling out of favor because there isn’t just one correct way to provide care.

Other factors include concerns about liability and risks to their license. While legally, veterinarians are not at risk from their state boards when practicing anywhere along the spectrum of medically appropriate options — provided proper informed consent is obtained — not all veterinarians understand or feel confident in this. That uncertainty contributes to fear of making a mistake or getting into trouble, which can limit the options they present to pet parents.

How does the affordability issue tie into workforce well-being?

Gilbreath: That’s a great question, and as an outsider to the industry, it’s something that’s puzzled me over the years. Surprisingly, the link between affordability and workforce well-being isn’t discussed more explicitly. Perhaps that’s because the affordability crisis has escalated quickly.

What we do see in the survey is how emotionally taxing it is for veterinarians to be unable to provide care. Veterinarians
enter this field because they care deeply about animals, and it’s incredibly difficult when they can’t help a patient due to cost. Watching a family walk away without care or worrying about a pet’s health is stressful, even if these situations are relatively rare. That stress inevitably contributes to burnout, dissatisfaction, and, ultimately, workforce attrition.

So how do practices start having those conversations upfront?

Gilbreath: That’s another tough question. The survey shows a disconnect between awareness and practice. About 88% of veterinarians say they’re aware of the concept of “spectrum of care,” and many claim they practice it. But when we ask more specific questions, the picture changes.

For example, when asked how they approach recommending next steps after a physical assessment, only 18% of respondents said they take what we consider a true “spectrum of care” approach — actively trying to understand the client’s goals and suggesting the option that fits the client’s needs, even if it’s not the most medically advanced. There’s a similar gap when it comes to considering financial constraints before recommending care. So, while veterinarians may be familiar with the idea in theory, fewer consistently put it into practice in a way that addresses both client needs and affordability.

Are there one or two steps you would hope practices will take after seeing this information?

Gilbreath: One of the most straightforward action items is improving the use of payment plans. They are drastically underutilized in veterinary medicine compared to their potential. In the pet parent survey, respondents said that if they had access to a consumer-friendly payment plan, they could afford twice as much care.

From an economic standpoint, this isn’t surprising. I’m not an economist, but I heard one speak at VMX who explained that when low-friction payment options are available, people tend to consume more at the same price point. Implementing payment plans that actually work for clients is a huge opportunity — and it’s something practices can do now. It doesn’t require waiting for new graduates trained in spectrum-of-care principles, although that would be ideal. Simply offering better, consistent payment options is a clear, actionable step.

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