Do Veterinarians Have a Behavior Problem?

Dr. Patty Khuly

A few years ago, I came across a similarly-titled veterinarian-authored article in a vet-directed publication. In it, my colleague reproached the profession for its lax ways when it comes to managing pet behavior problems. Given that shelter relinquishment for behavior issues leads to the number one cause of pet death in the US, he opined, veterinarians aren’t working hard enough at the root of the problem. Interesting argument, right?

It’s true. The more our culture turns to pets for comfort, caring, and companionship, the more pet owners are likely to identify problems with their behavior. That’s why board-certified veterinary behaviorists (veterinarians who undertake a residency in clinical behavior and pass a rigorous examination) are an increasingly popular addition to the cache of vet specialists at our disposal.

But having more board certified behaviorists doesn’t necessarily mean we have fewer problems. After all, we still have precious few of these specialists available to contribute to the general improvement of companion animal behavior. And according to this article’s argument, that’s at least in part due to the fact that veterinarians in general practice only seldom refer their patients to them.

Unfortunately, it’s hard to disagree with this observation. It’s true that many veterinarians in general practice seem to reserve a certain level of barely grudging respect for those who elect a field of practice viewed as “soft and squishy.”

Now, these are the same veterinarians enlightened enough to refer patients to internists, ophthalmologists, oncologists, and surgeons (among others). But then, these specialists practice medicine that tends to be viewed as “hard and crunchy” by comparison.

“Of course I’ll recommend my patients to neurosurgeons when they slip a disc and dermatologists when their skin starts sloughing in sheets - but a behaviorist for thunderstorm phobia? What are they going to recommend that I can’t?”

This is a sweeping generalization, of course. God knows not all vets will tilt their eyes skyward at the mention of behavioral medicine. Far fewer would openly admit to harboring a bias against behaviorists. Nonetheless, the number of young veterinarians entering this specialty area speaks to the reality of the demand for it: very low. And since veterinary behavior is a service that relies on referrals from general practitioners, low interest in residencies translates into low interest from within the profession.

Which would be okay. That is, as long as our clients were getting the services they needed to keep their pets behavior concerns under control. Yet it’s my opinion that few of us offer our clients the comprehensive behavior services they require.

I know I don’t. When I have a challenging behavior issue on my hands –– let’s say, a complex case of inter-dog aggression or a patient with an intractable feline elimination disorder –– I’ll either work with a trainer to help implement the behavior modification approaches I recommend, or I’ll refer to a veterinary behaviorist (who, unfortunately, is more than ninety minutes away). But the truth is, I dislike taking the former route given that I’m never sure I’ve done all I can for my patients unless they’ve seen the specialist.

Why? Because behavior medicine takes way more time and attention than I currently feel capable of devoting given my other responsibilities. And to be painfully honest, that’s because behavior medicine requires a lot of a veterinarian’s time… and doesn’t tend to pay well.

It’s been proven again and again by veterinarians everywhere: pet owners simply aren’t willing to spend the same sums of money treating a bad case of separation anxiety as they might another illnesses –– like, say, diabetes… or arthritis.

As an example, consider a simple exercise in profitability: If an owner comes in with a cat with an abscess, I can bring in $300 in thirty minutes with about $200 in supplies and staff time. But an anxious dog with severe noise phobia? Thirty minutes isn’t nearly enough to do it justice. And even $100 is more than most are prepared to pay for “just a conversation.”

See the problem?

The reason for this apparent incongruity is complex, but let it suffice to say that pet owners are kind of like most general practitioner veterinarians on this one: If the subject is something as smushy and tough to define as pet behavior, and the outcomes aren’t as well understood as for the “harder” specialty areas, does it not stand to reason that they’d elect to allocate fewer resources to it?

After all, behavior medicine takes not just expertise, but patience, time, and lots of hard work on the owner’s part too. Add to that the insecurity of not knowing whether all your hard work will have a good enough outcome and it’s clear that behavior medicine is a tough sell all the way around.

So to answer to my colleague’s question, it’s a resounding, “Yes. Of course veterinary medicine has a behavior problem!” It’s my opinion, however, that the problem has more to do with the nuts and bolts of the profession’s current financial structure than it does with its veterinarians’ enlightenment vis a vis the crucial nature of behavior to overall animal health.

Is there a solution? Ask ten vets and you’ll probably get eleven opinions, but here’s mine:

Veterinary medicine has made huge leaps forward in the last thirty years, largely because pet owners have demanded better care for their pets. I know it sounds callous, but they’ve done so by voting with their dollars. That’s how we’ve developed better drugs, better procedures, and better doctors. And that’s how we’ll get better behavior medicine too.

Nonetheless, this fiscal disconnect doesn’t give veterinarians a moral pass to abdicate our responsibility to pets on this issue. Though it would be unreasonable for anyone to expect us to give away our services until the financial climate catches up with the reality of our pets’ needs, there is a lot we can do by way of educating our clients. Because it’s only when pet owners understand what we’re all up against that the cultural scales will continue to tip further in our pets’ general direction.

How about you? Do you have an opinion?

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