I remember one M.D. commenting on a columnist, "We used to be in the 1% and now we're only in the 5%." There's been immense pressure from insurance companies to trim billings and make M.D.s more productive (in terms of patients per hour) and life as an M.D. has gotten a lot worse and worse paid. And I remember another article about the insides of the (small) industry of abortion providers, saying "it is blessedly free of managed care", meaning that the providers could largely charge what they wanted.
We had pets when I was young, in the 60s and 70s, and we didn't use vets much, only when we thought there was a serious problem. People have started to use vets like people started to use M.D.s in the 60s, dealing with every petty problem. But now people have started buying vet insurance, and I'm sure that vet insurance is starting to apply "managed care", much to the detriment of the vets.
Vet insurance is still, blessedly, a very small proportion of the market (about 10%), and much more immature than human insurance. They don't do managed care. The real pressure on vet practices is private equity.
> The biggest contributors to these are the twin demons of prior authorization and electronic medical records. Prior authorization is when health insurance companies require doctors to ask for permission to perform specific services for specific patients. This is incredibly time consuming (14.4 hours per week as of 2020) and also demoralizing for the physicians, as the ultimate decision on how to treat a patient is often not made by the highly-trained physician or the patient in need, but instead by a 25 year old making 40k/year reading off a script over the phone.
From what I've seen of algorithmic auditing literature in the context of health insurance, this is just a horrible tragedy. It means that despite high quality comparative effectiveness studies on optimal clinical decision making, insurance companies can often overrule good clinical & evidence based judgement
I think you need to do more research into the veterinary field… most vet clinics at this point are corporate owned, and we also have electronic medical records that take us forever to write. Also specialists in fields (like neurology) are increasingly common in vet med.
"Volk reckons about 25% of all companion animal practices in the U.S. are now owned by corporate consolidators. But that accounts for at least 40%, and perhaps closer to 50%, of all client visits, he explained, because corporations tend to own larger practices than independents, including a majority of U.S. specialist referral centers."
Dr. M and Trevor both have a point. From my experience, I have noticed that large animal veterinarians are more likely to own their own practice. These operations are much smaller in revenue and staff than an urban companion clinic, but each horse doctor carries their own tax ID. Urban clinics try to turn through patients every 30 min and are incredibly alluring to the large animal vet who is burdened with on-call and a significant pay cut from small animal work.
There was no legislation around electronic medical records for veterinarians, unlike for physicians. Any adoption of EMR by veterinarians is by choice, which was my point.
Agreed that vet specialists are becoming more common. But it's still nothing compared to the specialization of human physicians.
Something to note, despite these differences Veterinarians are also miserable. They have more that twice the suicide rate of human medical professionals.
Vets have to kill living creatures dozen of times per year, or even more often. This is terrible for their mental health. And they always have access to painless, powerful suicide drugs.
I remember one M.D. commenting on a columnist, "We used to be in the 1% and now we're only in the 5%." There's been immense pressure from insurance companies to trim billings and make M.D.s more productive (in terms of patients per hour) and life as an M.D. has gotten a lot worse and worse paid. And I remember another article about the insides of the (small) industry of abortion providers, saying "it is blessedly free of managed care", meaning that the providers could largely charge what they wanted.
We had pets when I was young, in the 60s and 70s, and we didn't use vets much, only when we thought there was a serious problem. People have started to use vets like people started to use M.D.s in the 60s, dealing with every petty problem. But now people have started buying vet insurance, and I'm sure that vet insurance is starting to apply "managed care", much to the detriment of the vets.
Vet insurance is still, blessedly, a very small proportion of the market (about 10%), and much more immature than human insurance. They don't do managed care. The real pressure on vet practices is private equity.
> The biggest contributors to these are the twin demons of prior authorization and electronic medical records. Prior authorization is when health insurance companies require doctors to ask for permission to perform specific services for specific patients. This is incredibly time consuming (14.4 hours per week as of 2020) and also demoralizing for the physicians, as the ultimate decision on how to treat a patient is often not made by the highly-trained physician or the patient in need, but instead by a 25 year old making 40k/year reading off a script over the phone.
From what I've seen of algorithmic auditing literature in the context of health insurance, this is just a horrible tragedy. It means that despite high quality comparative effectiveness studies on optimal clinical decision making, insurance companies can often overrule good clinical & evidence based judgement
I think you need to do more research into the veterinary field… most vet clinics at this point are corporate owned, and we also have electronic medical records that take us forever to write. Also specialists in fields (like neurology) are increasingly common in vet med.
"Volk reckons about 25% of all companion animal practices in the U.S. are now owned by corporate consolidators. But that accounts for at least 40%, and perhaps closer to 50%, of all client visits, he explained, because corporations tend to own larger practices than independents, including a majority of U.S. specialist referral centers."
https://news.vin.com/default.aspx?pid=210&Id=10652228
Dr. M and Trevor both have a point. From my experience, I have noticed that large animal veterinarians are more likely to own their own practice. These operations are much smaller in revenue and staff than an urban companion clinic, but each horse doctor carries their own tax ID. Urban clinics try to turn through patients every 30 min and are incredibly alluring to the large animal vet who is burdened with on-call and a significant pay cut from small animal work.
25% of vet clinics are corporate owned as of 2021 (https://news.vin.com/default.aspx?pid=210&Id=10652228) . It's not a trend I think is good, but it's still not most.
There was no legislation around electronic medical records for veterinarians, unlike for physicians. Any adoption of EMR by veterinarians is by choice, which was my point.
Agreed that vet specialists are becoming more common. But it's still nothing compared to the specialization of human physicians.
Something to note, despite these differences Veterinarians are also miserable. They have more that twice the suicide rate of human medical professionals.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266064/#:~:text=The%20rate%20of%20suicide%20in,the%20general%20population%20(3).
Vets have to kill living creatures dozen of times per year, or even more often. This is terrible for their mental health. And they always have access to painless, powerful suicide drugs.