Profit Pressures in the Exam Room

Sarah Mitchell

Hey everyone, welcome back to Looking through the microscope lens. I’m Sarah Mitchell, and today we’re talking about something that, honestly, I think a lot of us in the vet world feel but don’t always say out loud—how business pressures are changing what happens in the exam room. So, let’s just get right into it. You know, I started out thinking, “I’m here to help animals, that’s the job.” But lately, especially in bigger corporate clinics, it’s like, well, there’s this whole other layer—revenue targets, quotas, all that stuff. Take Banfield Pet Hospital, for example. They’re owned by Mars, Inc.—yeah, the candy people, which is wild—and they’ve been reported to set these pretty aggressive quotas for their vets. And, I mean, I get it, businesses gotta make money, but sometimes it feels like the focus shifts from what’s best for the animal to what’s best for the bottom line.

Sarah Mitchell

And that’s where things get tricky. I’ve seen situations where a vet is, like, nudged to recommend extra tests or treatments that, honestly, might not be necessary. It puts us in this weird spot—do you push for that extra bloodwork because it’s good medicine, or because you’re supposed to hit a number? I remember this one time, a senior vet suggested a dental cleaning for a dog that, in my opinion, really didn’t need it yet. I mean, the teeth were in pretty good shape. I actually spoke up—probably a little too bluntly, knowing me—and just said, “Hey, is this really needed right now?” It was awkward, but I couldn’t shake the feeling that we were crossing a line. And, you know, sometimes you wonder if you’re the only one who feels that way.

Sarah Mitchell

So, let’s talk about ethics for a sec. There’s this thing called fee-splitting—basically, it’s when a vet pays part of their fee to someone else who didn’t actually do the work. The American Veterinary Medical Association, or AVMA, is super clear that this is a no-go. It’s considered unethical because, well, it can mess with your judgment. Like, if you’re getting a kickback for referring a service, are you really thinking about what’s best for the animal, or just your wallet? I’ve heard stories—never saw it myself, but you hear things—about clinics where this kind of stuff happens under the table. It’s just not right.

Sarah Mitchell

And then there’s these standardized care packages. On paper, they sound great—like, “Here’s everything your pet needs, all bundled up!” But in reality, every animal is different. Sometimes those packages push treatments or tests that aren’t really necessary for every patient. It can take away a vet’s ability to make the best call for that specific animal. I mean, how do you balance making a living with making sure you’re not just selling a product? That’s the big question, right? I don’t have a perfect answer, but I think it’s something every clinic needs to wrestle with.

Sarah Mitchell

All this stuff—profit goals, weird incentives, standardized packages—it can really chip away at trust. Like, if clients start to feel like you’re just trying to sell them something, not actually care for their pet, that relationship gets shaky. And then there’s things like product diversion, where some vets have been caught reselling prescription products online or to retailers. That’s not just a policy issue, it’s a trust issue. If clients find out, it’s like, “Wait, are you looking out for my pet, or just making a quick buck?”

Sarah Mitchell

And honestly, the culture inside a clinic matters a ton. If you’ve got a toxic environment—like, people overriding treatment plans or just not caring about the rules—it’s way easier for ethical lines to get blurry. I’ve worked in places where, if you spoke up about something sketchy, you’d get side-eyed or even ignored. But I’ve also seen the flip side. There was this one client, super skeptical after a bad experience somewhere else. We took the time to walk her through every option, explained the pros and cons, and didn’t push anything extra. She actually said, “I feel like I can trust you guys.” That felt good. It reminded me that transparency really does rebuild trust, even if it takes a little longer.

Sarah Mitchell

So, what do we do about all this? I think it starts with training—like, real, ongoing training about ethics and how to talk to clients. Not just a one-time thing, but something that’s part of the clinic culture. If everyone’s on the same page about putting animal welfare first, it’s a lot harder for profit pressures to take over.

Sarah Mitchell

Another big thing is being upfront about pricing and why we recommend certain treatments. If you can explain, “Here’s why we think this is best for your pet, and here’s what it costs,” people are way more likely to trust you. It’s about informed consent, not just selling a service. And, honestly, I think every clinic should have some kind of ethical oversight—like a committee or even just a regular review—so there’s accountability. That way, if someone feels pressured to do something that doesn’t sit right, there’s a place to talk about it.

Sarah Mitchell

Alright, that’s all for today’s episode. I know this was a heavy one, but it’s important stuff. Thanks for listening, and if you’ve got stories or thoughts about profit pressures in vet medicine, I’d love to hear them. We’ll be back next time with more real talk from inside the clinic. Take care, and give your pets some extra love from me!