I still think it wil be a struggle to realize truly sustainable family farming outside of certain communities with ample access to a city ro niche market (think farms within easy access of NYC, Seattle, Philly, etc). 

As is I personally know several specialty market farmers with impeccable reputations that just can't make it when faced with new regulations, more inspections, higher costs, etc.... and these people have loyal customers who would lock heads with anyone daring to say the slightest negative thing about their beloved farms.  Honestly, sometimes it's really hard to make it unless you've got easy and cheap access to large markets. 

While in large farming it doesn't matter where you are, in small farming it's still about location, location, location especially in the age of increasing shipping costs.

If anyone is looking for some bodacious plants from farms that are goign under and need to get rid of some beautiful plants, send me a message,..

-horticulturalist at large

I sure wasn't thinking about people transporting their horses to other countries I guess I was imagining dogs and cats!

I know of more than one case when equine veterinarians have been transported from other countries to the U.S. in order to perform surgeries or procedures not routinely done in the U.S..  It is a project to transport a horse, but I think that's exactly what was done with one of the horses injured at the Beijing Olympics (transported to Australia for definitive fracture repair, I think, though I may be mistaken).

Stefani, After seeing people-patients travel from all over the world to Cleveland Clinic, whether US citizen or insured/not; I don't think it will be odd to see some marketing amongst clinics in the near future.

After all, we are bombarded with ads, newsletters, commercials of all kinds touting competition in human medical service/hospitals/.

Equine DVM, yes, I sure wasn't thinking about people transporting their horses to other countries I guess I was imagining dogs and cats!  But even so as you said, not feasible in emergency situations no matter what the size of the animal.  Maybe we won't see veterinary medical tourism in our lifetimes, but I did think that was funny about the Arkansas radioactive iodine place marketing themselves that way!

Patricia:

Vets depend too much on tests, vaccinations, and drugs.

Whoa, that's quite the generalization!

My clients will tell you we tailor their horses' vaccinations to their risk factors and needs.  As for tests, yes, I now recommend twice-yearly fecals... and as a result many of my clients target-deworm only those horses with high fecal egg counts.  Regarding drugs, I don't use antibiotics unless it's appropriate, don't hand out bute like candy, and usually recommend management alongside pharmaceuticals for gastric ulcers and chronic allergic airway disease.

Many of my colleagues practice in an evidence-based fashion, as I try to do.  I suggest you look for one of them when you select a veterinarian.

JoJo:

i live in the Wellington area now. Never have there been so many vets in such close proximity. I could use a new vet every 6 months and never repeat for years

Absolutely true.  A number of my clients winter in Wellington and have urged me to consider coming down for the season.  I don't doubt I could easily create a caseload but I don't want to live in Florida, even part-time.

Though i love my Equine vet, he's not too happy with me as i don't call on him as much as he thinks i should. As much as i used to, ancient pony and all!

I have clients like you.  They come last when I'm scheduling appointments.  It's nothing personal because many are very pleasant people.  It's a business decision for me, just as it's a business decision for them to do their own routine care and not to call me immediately with an illness or injury so we can figure out whether I need to come or not.  If a marginal client has an emergency and I'm available, I'll go. If I can't without inconveniencing another client (who may have taken a day off from work, etc.) or myself (mother's birthday party, etc.), I tell the client I won't be available for several hours and to call someone else or trailer to the veterinary college.  Frequently (though not always) these emergencies and appointments are more involved and difficult to treat, so the bill is larger, which is unrewarding for me, as the client then tells her friends I'm unreasonably expensive. I can't win.

Not all of these clients own ancient ponies, BTW.

Patricia, I'm glad someone else is voicing what I have said before the economy crisis---because in New England, I could see it starting. $40-50 a visit? That clearly was becoming unaffordable for most people, let alone the add-ons.

And to blame it all on recent grad debts, is not accurate, since a huge portion of the licensed professionals have been out of college for a decade or more, maybe 2-3 decades.

I was urged to fly/drive to the midwest for an experienced surgeon to perform my Pearl's IVDD surgery for 30% of what it cost here in New England.

So all these huge debt loads carried---where are the new grads going to "flock to"?

And as you mentioned, Patricia, very week I see a patron on my mail route newly unemployed and extremely worried, not only about health care but how to make it on reduced unemployment benefits.

I guess that makes #3 look more and more attractive!

Sorry about my comments...might have seemed disrespectful...Didn't mean them that way, though.

Dr. Khuly,

Of course you didn't mean any insult. Let me try to be a little more clear.

When I say "you get what you pay for" is arrogant, I mean it comes from an attitude we share in the Midwest and possibly the rest of the US. We think vet care, for example, can't be as good in Bulgaria as it is in the western suburbs of Illinois. And I'm sure we also think that only the vets who practice small animal medicine in these large practices with all of the bells and whistles in terms of equipment, and specialists, can adequately treat our pets. So we would have given up and put our beloved animals down instead of thinking to send the pet somewhere else for treatment. This man knew his dog would be well cared for except for the ordeal of the flight. He was confident vet care in Bulgaria would be good for his dog. And that punctured my arrogant attitude. And I'm sure that attitude was shared by the other listeners and they were equally surprised. We box ourselves in with a narrow worldview. Paying more isn't better when it means your dog is going to die if you can't afford treatment. And that is why I predict in the future as more people face his problem, someone will solve it with a website, connections, and honest services. Sort of like Travelocity, Orbitz. I don't think I am the only one who today finds vet care unaffordable and has been shocked by the rise in prices.

To me that is a part of the paradigm shift I see for the vet care industry. Costs have risen dramatically in the last, say 8 years.

Vets lose credibility when they rely on prescription diets even for cats that are largely made of corn and are cooked until they are nutrient deficient.  Annual vaccinations are an added threat.

Vets depend too much on tests, vaccinations, and drugs. Some people who are on my BarfingChicago list complain that a checkup for a pet with a condition ends up being $400 by the time they leave. They pay but they don't come back after they think things over. Vet visits become very rare as a result as no one wants to tell the vet they can't afford such care. It is hard enough to admit it to yourself. The vet who is going to reduce charges is going to be busier. Driving up costs with too many tests is counterproductive. Each additional test threatens the life of the pet.  It wasn't always this way. I left a vet practice I had been going to for 35 years when cat dentals became $550/cat. And i remembered my cats years ago didn't get dentals as they didn't need them.

Pet Insurance is not going to save things. Anyone who has had dealings with human health insurance will avoid the same experiences. And how will the companies make money unless they deny claims and take out administrative costs out of each dollar? Some of the people at my dog park don't go to the doctor themselves as their jobs no longer provide insurance and their employers have cut costs in other ways. They don't have salaries, they are contractors today. And not since the recession either but years before. They treat themselves by going to Whole Foods for herbs and homeopathic remedies. So your foot is broken, you live with it. They try to find alternatives and that is also what is going to happen to vet medicine in the future.

Better real food, fewer drugs, fewer tests, travel for services if necessary. Treating the cause of the condition not just suppressing symptoms. A search for alternatives.

Brebis thanks for the clarification. :) i don't know much about cattle. really? disbudding bothered you more then banding? i had slight problems with that. but when an animal doesn't show apparent pain, after the initial disbudd or initial putting on the band then i guess i'm ok with that. I've never seen the ravages though of a botched procedure. I hear it all the time on the goat lists.

My vet here castrated her two goats i gave her. i was there. Watched the whole thing. and then brought them home for another 3 to 4 weeks. At the same i banded one of mine. I worried more over her two then the banded one.They just didn't seem to be "back to normal" as soon as the banded one was. But here my vet thought me banding was cruel and inhumane. all of this is inhumane. I think circumcision is cruel but the benefits are vast. Perfect example of pet vs. livestock. I thought gelding was inhumane. yikes dripping blood for days on end?

Patty, come on up when its time.. How is tulip btw? showing yet? delilah is. and latte. and gracie. and magnolia... wheeee.

Equine DVM, i've had horses most of my life. and i live in the Wellington area now. Never have there been so many vets in such close proximity. I could use a new vet every 6 months and never repeat for years. ;) Though i love my Equine vet, he's not too happy with me as i don't call on him as much as he thinks i should. As much as i used to, ancient pony and all!

In human medicine, the downside is obviously you are dealing with THAT country's quality controls, or lack thereof.

Several months ago, I heard a young woman named Iva Scoch speak on NPR about being treated for cancer as a 20-something.  She is a Czech citizen and despite having U.S. health insurance, she found it more affordable at times to be treated in her home country.  In some instances, the quality of care was better than what she would have received in the U.S., too.  Fascinating.

I don't see many quality controls here in the US in vet med. I'm sure that there are MANY MANY countries in which veterinary medicine is practiced a lower level than here, but I'm also reasonably confident that there are at least a handful of countries where it is on a par with what is available here.

I'm sure you'd be alarmed to discover quality controls for human medicine are, in my opinion, as inadequate as you believe the standards are for veterinary medicine, but I digress.

The problem with veterinary medical tourism is, of course, it's just not possible to price-shop in true emergency situations.  In my area, the closest referral hospital for colic surgery used to be an 18-hour ride away.  That hospital used to see a lot of ruptured, toxic, dying horses.  Now, most of the horses I send for colic surgery live, because a quality surgeon is less than two hours away and time is the one huge factor that makes a difference in colic surgery survival.  I am delighted to have a nearby surgeon because, unlike one of my now-retired cowboy colleagues, I will not perform colic surgery myself in your barn under injectable anesthesia!

I tell my clients with uninsured horses to set some money aside as the animals' emergency fund.  Then I cross my fingers.

Not to push the thread even farther afield (or abroad) but medical tourism (flying to other countries, often India, to have procedures done) is increasingly popular for American humans, I don't know why it wouldn't start happening in vet med (as you discuss).

Makes sense.

In human medicine, the downside is obviously you are dealing with THAT country's quality controls, or lack thereof.  However, frankly, I don't see many quality controls here in the US in vet med.  I'm sure that there are MANY MANY countries in which veterinary medicine is practiced a lower level than here, but I'm also reasonably confident that there are at least a handful of countries where it is on a par with what is available here. 

I bet in the future there are lots of examples of "veterinary medical  tourism."

Anecdote: 

I have a foster kitty who is hyperthyroid.  I was discussing the future with the rescue vet (we are starting methimizole this week) and we were discussing Radiocat.  She told me there is a Radiocat in Arkansas now advertising they provide Radiocat for about $500 (compared with about $1,300 locally) and they are actually ADVERTISING this as in:  Get your kitty's radioactive iodine treatment AND a vacation for yourself all for the same price as Radiocat elsewhere in the country!"

LOL. She couldn't vouche for them quality wise and I have no burning desire to visit Arkansas, but it's definitely a competitive ad campaign.

I'm still wondering why an amputation isn't a viable alternative to euthanasia...or shipping a dog to Bulgaria. But that's just me.

Dr Khuly,

I don't know the particulars of what needed to be done for this dog's leg.  I just listened to his story.  Even though money is a taboo topic as no one wants to admit they cannot afford to care for their pets, I do know of a couple of fairly recent cases that give an indication of what $5000 buys in the western suburbs of Chicago.  $5000 will buy surgery to remove an intestinal obstruction caused by pieces of a tennis ball in a dog.  The owners paid the amount and saved the dog.  $5000 will buy 5 days of animal hospital care for pancreatitis with no guarantees it wouldn't be longer.  The owners put the dog down.  Who is to say an amputation wouldn't be unaffordable for this gentleman?

What amazed me was his willingness to not take the vet's recommendation.  Instead he paid for some care and took his dog home.  There he thought about his options and asked family members to get information for him which led to him shipping his dog to Bulgaria as family members could get care for the dog cheaply.

If this happens to me in the future maybe I can call my brother and sister in Iowa for help.  Maybe there is a vet there who would save my pet at a price I can afford.

But my prediction stands. In the future pets will be stabilized in emergency rooms and shipped to other countries for treatment.  Unless they are shipped to other states where care is cheaper.  Who knows maybe like the van our Canadian contributor Brebis noire mentioned, enterprising people could take animals to places where procedures are performed more affordably.  Vet location will be less of a factor.

Also one note on semantics: dehorning is not disbudding. Nobody i know does their own dehornings. Done by a veterinarian under anesthesia, I hear its a complicated surgery, while disbudding a 10 day old kid? We do it here on the farm.

There was a recent lengthy discussion of dehorning on an equine veterinary listserv of which I am a member. The veterinarian who presented the question did only equine, no small ruminant work, but had been asked to dehorn a small ruminant for a "friend". The consensus on the listserv was to refer the "friend" elsewhere if he wouldn't be dissuaded, as those veterinarians who had dehorned adults reported it was a major, bloody surgery with a prolonged, painful recovery period.

In contrast, Brebis noire is correct that dehorning can be performed reasonably safely - though not, in my opinion, entirely humanely - in adult cattle by laypeople. Sometimes cattle are vaccinated, dewormed, castrated, and dehorned, all at once. As for disbudding, it's easy to fry a goat's brain if one uses equipment designed for cattle, not specifically for goats. I still remember the photo we were shown in veterinary school in order to illustrate this clinical pearl.  But JoJo is correct that disbudding is routinely done by laypersons and is reasonably safe - though I do think it is painful when done without local anesthesia.

dairy goats are pretty much ignored in the vet field on average anyway

Yes, because very few people will pay a veterinarian more than the cost of the goat to treat goats!  My basic operating expenses are the same, whether it's a $300K colicking grand prix jumper or a $25 blocked wether (or a $25 colicking ancient pony, for that matter).  Additionally, in my area, there isn't a concentrated population of small ruminants, even if every owner used a veterinarian vs. DIY, so the clientele wouldn't support a dedicated small ruminant practice.  The same is true for swine, poultry, camelids, cattle, and most small exotics, BTW.

Furthermore, for someone like me, who doesn't treat small ruminants routinely, the probability of providing substandard care to a small ruminant is unacceptably high.  Since I think it's important to treat ancient ponies with the same care with which I treat grand prix jumpers, it follows that I am also concerned I cannot offer that level of care to small ruminants.  Thus, I stick to horses, because the population is large enough to allow me to gain expertise and earn a living (see Dr. Khuly's #5).  Small ruminants are not small horses.  If someone calls with a small ruminant problem, I refer to a food animal practice about an hour from my region or to the veterinary college, about three hours from my region.  If it's a pet, the client usually thanks me.  If it's an (alleged) food animal, I've had clients threaten to shoot and eat it... which I tell them is an option!

I'm still wondering why an amputation isn't a viable alternative to euthanasia...or shipping a dog to Bulgaria. But that's just me.

Well, yeah. I'd argue it's also more humane to amputate vs. subject a dog with a "destroyed" leg to an airplane ride to Bulgaria, presumably in the cargo hold.

Coincidentally, a current discussion on one of my equine veterinary listservs concerns amputation techniques in goats with non-unions. (It's winter and a lot of equine veterinarians are indoors, bored.)  FYI, according to my colleagues on the listserv, three-legged goats generally do just fine.

jojo, dehorning a goat is not like dehorning a calf or a cow. Goat horns are more complicated anatomically (with two nerve sources) and they express themselves more vociferously and thus their owners care more about their pain. Bovines are often dehorned without anesthesia because they are considered not worth the expense of a few mls of lidocaine, or there is no vet on hand to do it. I've seen them dehorned when they're processed at feedlot entry: a bloodly and painful procedure that adds insult to injury in the overall stress of entering the feedlot hell. 

I always used nerve blocks before dehorning, it's very easy with bovines. Most goat farmers I used to know disbudded at a few days old, without anesthesia, because they considered the risk of general anesthesia (and even potential lidocaine toxicity on young kids) to be worse than the procedure itself. Those kids sure can cry, though they stop pretty quickly once it's over. I gave up raising goats partly because I couldn't cope with the stress of that procedure, and couldn't come to terms with using general anesthesia for every kid who needed dehorning.

I'm a small farm. And  didn't set out to be. So I come from the pet perspective and moved into this farm thinking. And have to agree with Equine MD. If i can do it myself chances are i will, or will learn to. I have 10 dairy goats, and a smattering of other animals.

Many of us that do jump from pet to livestock are making this a better place for animals. We bring a slightly more empathetic view to many of the issues. Many times a breeder tells me to cull. I don't. I fix. If i can. but hard facts ( and costs) can't be ignored. One dog, one cat, one horse and one goat wasn't an issue to call out a vet for minor things... I have moved more towards the large farm mentality when sided with vet care costs. I'm sure many small family farms do too.

I've had ONE episode where a turkey (pet turkey) needed surgery. Dogs bit a hole right thru to the body sac, he couldn't breathe and would surely die. And for this guy to LIVE he needed stitches. I called in a friend favor and they stitched him up. THis is a food animal that crossed the line to pet. Surgery would have cost me $500/$1000 more? It was a wake up call.  What to do considering how attached i got to him. pet? food? It helped me realize where i need to draw the lines on some things. I love my animals dearly... But i can't afford that kind of vet care for all of them. Not the way vet care costs today. and i surely can't call a vet out when i need to do the basics in farm management.

The more we learn (we, being the new urban small farmer) realize that there is a steady group of reasons on what goes wrong with animals (birthing, ailments, husbandry, management, parasites) you learn you can tackle much of it yourself. I give my own vaccines to all the animals now. Horses included (which i used to pay upwards of $300 a visit for that). I worm all the animals, dogs and cats (buying in bulk is the only way now). I treat my own animals based on knowledge i get from long time breeders with 30 + years of knowledge in whatever animal discipline. (dairy goats are pretty much ignored in the vet field on average anyway).  To be able to do what i do, and afford to keep on doing it, I can't be calling out a vet every time fluffy gets the sniffles. Broken legs? yes need a vet. Pnuemonia? no. My poor turkey? likely would have been put down had i not lucked out.

Also one note on semantics: dehorning is not disbudding. Nobody i know does their own dehornings. Done by a veterinarian under anesthesia, I hear its a complicated surgery, while disbudding a 10 day old kid? We do it here on the farm. Nerve blocking would be a nice thing, but i've seen enough done (on my own kids) that once done and given a bottle they are back to normal in minutes.

So i guess i don't think that the future 10 year prediction on #3 is going to change all that much.

The low-cost spays and neuters in my part of Canada used to be done by two semi-retired vets in...Vermont. People used to organise trips, schlepping a bunch of cat carriers over the border in their cars. Now that those vets are truly retired, the low-cost market is being filled locally, because too many people would otherwise let their cats (especially) go unspayed and unneutered. 

Patricia, ME too! I could have easily achieved quality care for a fraction of price paid, with a 4 hour trip north to Canada and was often invited to do so by a good friend.

Realistically, though it should not matter (ethically), I was reluctant because what about "follow up care" or emergencies? That is where I held the belief to continue care with ONE vet, ONE facility.

Obviously stupid thinking and 20/20 hindsight proved it!

After all, I believe over the period of 5 years , my Mom went to "3" different hospitals, had "2" sets od specialists and no one concerned or "miffed", and more importantly---lowering the standard of care.

Patricia, this is slightly off-topic but related to your concerns. A good defense against teeth expence is raw feeding, including meaty bones, such as in chicken necks. Cats can go without cleaning, either at all or for much longer.  

Brebis noire,

I think in the future you will be able to bid on the work if you live near an airport or good transportation.  Someone out there will manage through the internet a service where people in such a position as this gentleman can put out work for a bid which includes transportation and recovery for the pet.  Talent in the cities will no longer be rewarded when the charges are excessive. Excessive meaning unaffordable to the middle class.

The concept of "you get what you pay for" will change.  Perhaps even routine measures will be included and someone will manage the transportation route and work to be done.  I became interested in charges when I paid a total over $3,500 for the dentals of my three cats who had dentals every year for 5 years.  The charges began at $150 per cat and climbed to $550 per cat.  I changed vets and it was from the frying pan into the fire and a huge shock.  So I took out a credit card and worked on paying it off my cats' dentals for 6 months.  I became much more aware of charges and the bitter choices people have to make.

So I see an opportunity for an enterprising vet with a website, connections, and a good reputation. 

Patricia, I totally understand why a person would do that, given the economics of the situation. It is screwy that plane fare (person plus dog) plus surgical and other logistical costs should be lower than having the surgery done locally. On the other hand, putting their animal through the stress of travel is part of the "getting what he pays for" equation. However, maybe he was lucky this time: maybe monitoring during surgery would be considered sub-par by our standards.

I'm a vet, though I work in a part of North America where vet costs are lower than most places. I shudder whenever people in cities tell me how much they paid for various procedures or surgeries. But they also have to live in those cities, and pay off their tuition debts and/or diagnostic imaging and testand treatment apparatus.  

What we are witnessing appears to me to be payoff for our unsustainable modes (not standards) of living.

Regarding the dog sent to Bulgaria to have his destroyed leg put together.  The fact is the man faced a horrible choice.  Pay the money or destroy his dog.  He couldn't pay the money and he found an alternative.  The estimated cost was over $5000 in the Chicago area and that didn't include aftercare.  This was an amount the owner did not have.  The owner has his dog back in good health rather than destroying the dog or trying to find a rescue who could afford the cost.  You may arrogantly say "you get what you pay for." This is an arrogant view when the alternative is destroying the dog or in a better case giving up his dog to richer people or a charity. This man did his best for his dog.  The economics make such decisions difficult if not impossible.  He found a possibility that worked for him and worked for his dog.

Actually in our own country and perhaps in my own state there are ways to give this dog what he needed at lower cost and people with business sense will fill that need for us in the future. Because the middle class does not have the money anymore and people will still continue to love their pets.

Dr. Khuly:  I simply don't think small farmers are going to provide sufficient caseload to employ larger numbers of food animal veterinarians.  We see this in equine medicine, too; less farmland = fewer patients, longer distance between farms, less knowledgeable clients (how does one charge appropriately for education about... everything?).

Yes, it's healthier to know where your food was produced (I belong to a vegetable CSA myself), but it's also expensive.  It would be cheaper for us to buy our vegetables at Whole Foods.  We're aware this is a luxury.

I guess I hope you're correct regarding improved food animal welfare and grassroots small farms, but I don't forsee a future where food animal veterinarians are either more in demand or given more of an opportunity to behave like veterinarians.

I was just reflecting on the fact that surgery is one of the last manual jobs that cannot be outsourced to cheaper locations, then I read Patricia's post above.

Thank you Dr. Khuly for making number #1 , number one.

www.kahramanveterinerlik.com

#1 - Some of my patients are worth $100K+ in economic terms. My malpractice premiums already reflect this reality. Not concerned.

#2 - Because the veterinary field frequently attracts students with romantic rather than realistic visions of life as a veterinarian, I think the crisis will be economic - for veterinarians. Those who have large student loans will be less likely to purchase or own practices (already seen). More veterinarians will work part-time or moonlight and/or rely on a partner's income to support a family (also already seen).  More veterinarians will come from wealthy backgrounds (definitely already seen, perhaps exaggerated among veterinarians entering equine practice, which offers very low starting salaries and requires horse experience beyond that offered in veterinary school).

#3 - Veterinarians may become involved with small farms. Larger farms, however, frequently use veterinarians only minimally. Why pay a veterinarian when it's possible to purchase drugs and vaccine OTC? Larger farms perform their own castrations, dehornings, and palpations - some even own U/S machines. It's cheaper to cull than pay a veterinarian for a C/S or LDA surgery. This has a twofold effect upon "small farm" large animal veterinary care: 1. fewer veterinarians are available (since they've been replaced by laypeople and, well, it's a tough life) or interested in large animal practice, period, and small farmers aren't going to easily reverse this trend because by definition they own only a few animals  2. small farmers are likely to adopt the attitude of large farmers ("the cow is only worth $X and you're telling me it will cost more than $X to fix her?"). It's either a food animal or a pet. Clients will pay to fix a pet. Clients tend to cull and eat the food animal.

#4 - Again, many of my patients are insured. It is not a panacea. I'm not going into the reasons here other than to say take a look at the human health insurance industry and imagine something less regulated and more maddening.

#5 - Actually, I envision renewed discussion of required internship and/or residency training.  Limited licensure may very well become reality, but it's a band-aid.  Unfortunately, new graduate veterinarians are not, economically, worth the starting salaries most of them require to pay back their student loans.  We need to fix this.  I don't know how we're going to pay for it, though.

Oh I figured it out.

I testified for this bill, which would have allowed LIMITED non-economic damages if a vet is JUDGED (key word, not allegations, but legal determinations) to have deliberately killed your pet in bad faith (maximum $7,500) or due to "gross" negligence (maximum $2,000).  These provisions were stripped from the bill (surprise surprise, DCVMA and Pet Health Industry out in force, pressing the flesh and getting their cards into the hands of council) but there will be more of us.

I'd suggest the field get in front of it.

http://www.youtube.com/watch?v=dYV7KcZYCAU

Wow, thumbs up Stefani! And Patricia" another WOW!

Less personal: I believe in the next decade the AKC will open the stud books to some diversity in the gene pool. This has already been attempted with Sealyham Terriers to a *very* limited extent and may be followed by other breeds. JMO.

I think there will be a paradigm shift in vet medicine.  In recent years more vet medicine (tests, drugs0 is seen as better vet medicine.  And it doesn't work. In the future there will be better foods, less drugs and fewer tests.

Too many tests lead to wrong treatments, diagnoses, mistakes that don't fit physical symptoms.  Vets believe in the numbers rather than what is in front of their eyes.  And it leads to over treatment.

Too often vets prescribe food that is made of poor ingredients like corn and grains even to cats.  In the future owners will realize good food real food is medicine.

The word will get out that annual vaccinations are bad for pets and a rip-off for the owners.

Vet costs are beginning to be unaffordable in the urban areas.  I think some animals will be stabilized in the US and shipped to other countries for surgery and big ticket care.  This has already happened at my dog park.  The Shepherd was stabilized in a Chicago suburb, and flown to a cousin in Bulgaria for surgery.

Owners will put less faith in pedigreed dogs and cats as they see health issues in these animals and become aware of inherited deformities.

Cancer in humans and pets will be seen as a system wide disease and treated as such.  Taking out a tumor doesn't work as more pop up elsewhere.  Treatment will focus on the helping the immune system.

Are links disabled?  I wanted to give you some links on this issue . . .  the link icon is grayed out.

Thanks Dr. K on #1.  Odd we're among your most loyal readers . . . there is a reason for that.  We just want good, competent, conscientious and HONEST care for our furry (and feathered, and scaled etc.) loved ones.  

I'm all for debt relief for vets.  After all, I can't be screaming about raising quality standards and not be supportive of all those things likely to make it easier to practice at a high level.

The prediction I will add:

A major show will break open the taboo topic of veterinary malpractice, raising awareness.  Pet owners (the ones who consider pets part of the family, NOT the "property rights" crowd) will form THEIR OWN Political Action Committee and begin making their presence known as a lobbying force.

To be completely honest, I find myself cringing a little (maybe a lot) at #4... not a fan of veterinary insurance, and not looking forward to the possibility that a time may arise when I have little choice but to opt for it.

Yowzers, Dr. Steve, $250?  I'm jealous!  :)  I just got accepted to CSU and am looking at $20,000 a year for tuition (that's the in-state rate, too--lots higher for other folks).  I have to agree with you--before taking on this much debt (especially in my mid-30s), I made darn sure that veterinary medicine was something I wanted to absolutely devote the rest of my life to.  Hopefully that kind of commitment will lay the groundwork for being a great vet someday.

By the way, in honor of being accepted, I am doing something a little crazy: <a target="_blank" href="http://www.holycowproject.org">www.holycowproject.org</a>

I'm a bit of a lurker on this blog, but I wanted to say thanks to everyone who reads and comments on these posts, and thanks to Dr. K for writing them.  It's helped me be sure that being a vet is the right choice for me, and, I think, is giving me good insight into lots of different pet owner perspectives.  Shouldn't Dolittler be mandatory reading for all future vets?  ;)

IMHO:

#1 will never happen - not if you want to keep $35 exam fees...

#2 will be a blend of private school competition with public land grant schools (see #5), and higher salaries for graduating vets, and the loss of $35 exam fees...

#3 Sure, should be fun - except who is going to care/treat (we can't even cover agriculture!) - especially if #1 happens? No $35 exam fees there.

#4 More common, yes - mainstream, no.  The veterinary infrastructure (education through medical records) will not support CPT coding until standards of care are outlined, and loss of $35 exam fees...

#5 Absolutely, 100% agree!  With this will come private education centers in urban areas which will domino better education, lower tuition, lower costs to clients for academic-level care in surrounding areas, better clinical training for veterinarians and technicians alike, and might just serve to keep the $35 exam fee.

Dr. Khuly writes: Finding a great veterinarian gets much tougher should professional standards decline due to the steep price of a veterinary education.

Since my average yearly (UP vet school) tuition was $250 (1960 - 1964), does that make me 150 times greater than recent graduates?  One might argue the opposite -- especially if you know me -- that the economic sacrifice made by today's veterinary graduates makes it even more likely that they are "great veterinarians."

Thank you Dr. Khuly for making number #1 , number one.

Wayyy back, over two years ago, finding this blog and posting was a way to "come back" to mental health for me personally.

Some of got to "know" other posters, experiences, and opinions despite never having met. This would have been nearly impossible a little over a decade ago.

A couple of years ago, I was bashed, attacked, and be-littled by other posters for daring to have the guts to talk about veterinary abuse, malpractice, deception, and cruelty. Among various blogs, I also posted about my experiences with exceptional quality my pets had received over the years.

Never in my entire life, would I have imagined experiencing what I did in October of 2006, never would I have chosen to STAND up and fight back about what happened in the ONLY way left to me: the legal forum.

And NEVER in my life would I have expected a cross-counter-suit to intimidate and shut me up from stating the truth. I am a United States Citizen. We have 1st amendment to allow us to voice our concerns, experiences, and share with people.

Now my suit is two-fold and yes, costly beyond measure in dollars and harm.

Economic damages? Replacement costs? Not even part of my suit. I never claimed that Pocket was "savable"---not ever. She was in fact, in the midst of dying , just as all pets must do eventually. Why the hell couldn't she have done that peacefully, kindly, and ethically?

I'll never be able to resolve that in my heart---not ever! But shut up? Never.

We resolve to teach Wyatt some manners. Happy New Year!