Over the past week, I’ve found myself circling an all-too-familiar unease with the state of veterinary care and the question of access and affordability. It started again with the release earlier this month of the PetSmart/Gallup State of Pet Care Study for 2026, particularly the way veterinary attitudes toward pet owners were framed through a forced-choice question: “If you had to choose, which of the following best represents your view, even if neither matches exactly?” Two choices were presented:
- It is the responsibility of the veterinary industry to make veterinary care affordable
- People should not own pets if they cannot afford the care at current market rates
The fact that 63% of 933 responding veterinarians said “people should not own pets if they cannot afford the care at current market rates” was profoundly disappointing and disheartening to me – if not entirely surprising. It echoed things I’ve been reading, hearing, and sensing for months…or more accurately, for years.
Then, this morning, I came across a comment in a veterinary forum that further added to my discomfort. On the currently very hot topic of whether to pass credit card fees along to clients, one commenter offered this advice to practices: “If clients push back on being charged credit card processing fees, staff should remind them that the alternative would be to raise prices. They’ll just be universally happy that you didn’t raise prices!“
The clear subtext was that clients are so intimidated by the prospect of higher prices that they will comply and even forget that they’re still paying more, just in a different form. It was a coercive choice presented as an inevitability: accept this quietly, or we can make things worse. It came across as a thinly veiled threat.
This kind of attitude (and recommendation) has no place in what is supposed to be a care environment. And taken together with so much else we’re seeing, it points to something deeper than a disagreement about fees. It suggests that veterinary medicine has drifted into an increasingly adversarial relationship with its own clients, which makes little sense in a profession built on…caring?
From where I sit — in a role that supports veterinary teams rather than operating within the clinic — this reflects a long-standing pattern in veterinary medicine: the tendency to separate the pet from the client in how care is conceptualized and delivered. The animal is framed as “the patient,” while the human becomes a separate, complicating factor — a financial obstacle, an emotional burden, something that interferes with doing what’s “best for the pet.”
At times, it seems as though the client is viewed as nothing more than a clunky appendage the pet dragged in through the clinic door — not fully part of the patient, except insofar as they’re holding the credit card needed to pay for services. The human becomes incidental, tolerated – even in the way – rather than understood as essential to whether care can actually happen.
But as we all know, the pet never arrives alone. The pet and the person who loves them walk in together, and they cannot be meaningfully treated as separable.
I’ve begun referring to this inseparability as Pet-in-Relationship™ — simply to name and better understand the reality that the pet and their human arrive together as a unified whole, rather than as separate problems to be managed. Thinking this way helps clarify why separating them so often pushes conversations about care — and its cost — into conflict.
I’m not suggesting this is a new insight. Variations of it already exist in veterinary medicine — in discussions of empathy, communication, and contextualized care. What I’m doing here is pulling on a single specific thread in this knot to help me think more clearly about how to move cost-and-care conversations forward.
This lens is also influenced by a concept I learned about over 30 years ago, when I briefly attended social work school at the University of Maryland: the idea of person-in-environment. The core insight is the same — you cannot understand or serve a being outside of the relational and material conditions that make their life possible.
When the Pet-in-Relationship concept is kept intact, something shifts. Affordability can be treated as a legitimate care variable rather than a personal flaw. Flexibility becomes part of good medicine rather than a concession. And conversations that so often feel adversarial have a better chance of moving out of conflict and back into collaboration.
I’m going to continue developing this concept of Pet-in-Relationship and building educational content around it, with the hope that it helps reawaken memories of vet med’s heritage, rooted as it is in relationship-centered care.
As part of that work, I’ve created a visual expression of the Pet-in-Relationship concept — simply as a way of holding the pet and their human together in view, rather than separating them in our thinking about care.
I welcome your thoughts and comments.
More to come.
Stay tuned.
The Pet-in-Relationship™ framework reflects ongoing work developed through VetBilling to support relationship-centered approaches to care.
Please credit Suzanne Cannon and VetBilling when referencing or sharing this framework.