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A long list of top-tier media outlets has spent the past couple of years tarnishing our reputations in their pages and podcasts. While it's not veterinarians, exactly, who are the object of their criticism, we might as well be. Our industry and its rapidly altered economic foundation may be what's skewered on the pointy end of the media's stick, but it's veterinarians who come away from these exposés ripped to shreds.

While I welcome any critique of our industry that exposes all its unsavory shenanigans (and, I confess, I'll sometimes experience a savage kind of glee from reading them), the irony is the average reader isn't savvy enough to understand veterinarians are not the cause of their astronomical pet healthcare bills.

Though these publications may take great pains to exonerate us as best they can, explaining veterinarians are but a cog in the corporate machine who suffer even greater moral injury than our clients, it's the headlines that matter (i.e., "Help! I Feel Like I Am Being Ripped Off By My Vet!"¹)

This is especially true when the splashy titles neatly reinforce a growing consensus among consumers with attitudes like: "It's not just you. Veterinary medicine is immorally expensive, and somebody somewhere is getting rich from the proceeds of your love for animals." Never mind that you might be further from rich than your average client…you'll still be the one they'll blame.

 

How it once was

Our profession was once considered tops on the respect-o-meter. We were viewed as kind, compassionate, altruistic, and giving. Take James Herriot, for example. He was considered affordable enough to be approachable. You could talk to him if you didn't have money to spend and count on him to make things happen within those constraints. That's who we once were perceived to be. It wasn't necessarily better or worse; it was just a different sort of social contract than we offer today.

How it is now

Of course, things have changed. Medicine is more formal given that a) it's more technically advanced and b) more is at stake, given how we perceive our pets. The relationship we have with our clients today is not, "Well, let's see if he makes it through the night." It's more likely to involve an ultrasound, a specialist, a CT scan, round-the-clock hospitalization, and an estimate whose bottom line can rival the price of a decent used car.

None of this is inherently bad. In fact, most of it is wonderful. We can save animals we couldn't have dreamed of saving 30 years ago. However, somewhere along the way, our increasing sophistication also changed what clients expect of us

Something changed

I'm not prepared to say people don't trust veterinarians anymore. There's surprisingly little longitudinal research to prove that, and I'm wary of accepting the prevailing veterinary narrative simply because it feels truer today than when I started out.

That said, something has clearly shifted. Clients increasingly describe feeling pressured, judged, rushed, nickel-and-dimed, or simply unheard. Veterinarians, meanwhile, describe feeling distrusted, emotionally exhausted, financially squeezed, and terrified of complaints. We worry about boards, lawsuits, Google reviews, and the possibility that anything short of the maximal diagnostic workup will be characterized as substandard care. Everyone feels victimized. Nobody feels understood.

Cost is obviously central to this mess. In the 2026 PetSmart Charities-Gallup State of Pet Care study,² 94 percent of veterinarians said clients' finances sometimes or often prevent them from providing recommended treatment. Yet only 17 percent said they try to understand a client's financial concerns before making treatment recommendations (almost half do so only after presenting their recommended plan). That sequence matters.

 

What clients are actually angry about

I believe angry clients don't "hate" veterinarians because we're expensive. They blame us when we don't seem to care.

That distinction is important. Yes, veterinary care is expensive, but clients don't necessarily become furious simply because something costs $5,000. They become furious when the $5,000 estimate lands in front of them unexplained, apparently immutable, and accompanied by the unmistakable implication that declining any part of it makes them a bad pet owner. (Sign here…right where it says "against medical advice.")

We've known for years clients want us to discuss money. A veterinary focus-group study found that pet owners expected veterinarians to initiate frank conversations about costs, and suspicion about veterinarians' financial motivations emerged when those conversations went badly—or didn't happen at all.

Then there's the other complaint I hear constantly: Nobody gave me any options.

This one bothers me because it's so fixable. Veterinary medicine spent years elevating "gold standard" care to something approaching a moral imperative. Offer the ultrasound, the referral, the culture, the biopsy, the hospitalization and the whole diagnostic enchilada. Document everything declined. Get the AMA signed.

Somewhere in there, "This is what I recommend" too easily became "This is the only medically defensible thing I can offer." But it isn't.

 

How we got here

Corporatization deserves some of the blame, though probably not all the blame it gets.

Corporate ownership has brought veterinarians better equipment, better benefits, better pay, professional HR, continuing education, and systems many independently owned practices could never provide. However, systems built for consistency and efficiency can also make individualized medicine harder. Standardized estimates, production expectations, and less latitude over pricing can leave us standing in an exam room defending a bill we didn't entirely create.

Meanwhile, young veterinarians arrive carrying substantial educational debt and enter a profession where discounting their labor is no longer financially sustainable. Everyone is working faster. Clients expect immediate callbacks. Staffing remains difficult. Medical records have become legal documents of almost absurd proportions.

Those financial limitations themselves take a toll. One JAVMA article³ found 57 percent of surveyed small-animal veterinarians said clients' economic limitations affected their ability to provide desired care every day; about half reported moderate-to-substantial burnout, with financial constraints frequently contributing.

So, we protect ourselves. We document harder. We adhere more rigidly to protocols. We ask clients to sign things. We practice defensively. This is all understandable; unfortunately, defensive medicine can feel suspiciously like indifferent medicine from the other side of the exam table.

 

The spectrum of care approach

There's increasing support within veterinary medicine for a spectrum-of-care approach precisely because acceptable care can exist at multiple price points. The above-mentioned research on veterinary decision-making similarly found discussing financially diverse options can help overcome barriers to care, with veterinarians themselves describing a shift away from a singular gold-standard model.

Sometimes good medicine means doing one diagnostic instead of five. Sometimes it means treating presumptively. Sometimes it means outpatient care instead of hospitalization. Sometimes it means saying, "Here's the ideal plan. Now tell me what's possible, and we'll figure out what makes the most sense."

That last sentence may be worth more to our reputation than any amount of marketing.

 

There's more we can do

Here's where I think veterinarians have more power than we sometimes admit: Not every invoice is set in stone. Not every protocol has to be all-or-nothing. Not every pet needs gold-standard medicine. Not every deviation from an ideal recommendation constitutes malpractice. Also, an AMA form should never substitute for a conversation.

As professionals, maybe we're identifying too much with the standard of care and not sufficiently with the standard of caring. Because I don't actually think clients are angry we're too expensive. I think they're angry because they often feel they have no partner in solving problems.

For example: Someone can decline your $5,000 estimate and still leave your hospital enormously grateful because you listened, tried, offered alternatives, and respected the financial reality of their life. Conversely, someone can uncomplainingly pay $5,000 and leave furious because they felt bullied, dismissed, or treated like a liability instead of a client.

We do have the power to change that perception.

 

Where we go from here

Whether our reputation has objectively declined remains an open question. Yet mainstream reporting, concern within the profession, and the extraordinary visibility of online consumer complaints all suggest the veterinarian-client relationship is under strain.

What isn't in question is many veterinarians feel less trusted while many clients feel increasingly unable to afford us: Those two problems are feeding each other.

We measure burnout, compensation, debt, workforce shortages, and employee engagement with increasing sophistication. Maybe it's time we measured something else, too: our profession's social license to practice.

Until then, I'd start with something considerably less sophisticated: Don't let rigid practice policies dictate your professional life. Recruit some of your boundless humanity and ask your clients what they can manage. Give them choices and always make damned sure they know you're on their side.

Patty Khuly, VMD, MBA, runs a small animal practice in Miami and is available at drpattykhuly.com. Columnists' opinions do not necessarily reflect those of VPN Plus+.

References

1. https://askavet.dogster.com/vet-answers/help-i-feel-like-i-am-being-ripped-off-by-my-vet
2. Coe JB, Adams CL, Bonnett BN. "A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care." Journal of the American Veterinary Medical Association.2007;231(10):1510–1518)
3. Kipperman BS, Kass PH, Rishniw M. "Factors that influence small animal veterinarians' opinions and actions regarding cost of care and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout." 2017;250(7):785–794.)