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March 15, 2021

Report offers insights into COVID impacts on veterinary practices

Findings inform strategies for practices to weather long-term emergencies
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Shortly after the COVID-19 pandemic reached the U.S. in 2020, the AVMA surveyed hundreds of veterinary practice owners to understand how day-to-day operations at their hospitals were affected.

A new analysis of the survey, fielded in April, provides a snapshot of the scope and breadth of the novel coronavirus’s impact on the U.S. veterinary profession. The analysis identifies various strategies that practice owners adopted to continue seeing patients while protecting staff members and clients.

In January, the AVMA published the survey results online in a report titled “COVID-19: Veterinary Impacts and Responses.” Results from the April survey and an additional June survey are posted in an interactive dashboard.

The report on the April survey includes analysis by AVMA economists in the areas of overall impact of COVID-19, operating hours, cash shortfalls, and productivity.

The report offered the following insights:

  • Because the impacts of COVID-19 vary by geography and over time, it’s important to have strategies ready for different scenarios. For example, both reduced and increased client traffic.
  • A continuous flow of reliable information from trusted sources can help veterinarians implement best practices and alleviate client and employee concerns.
  • Telemedicine, consistent with state and federal requirements, can be a useful tool to help practices optimize operating hours both in person and virtually.
  • Practices should try to keep a ratio of nonveterinarian staff members to veterinarians that maximizes labor utilization. Research has shown that the optimal ratio of veterinary technicians to veterinarians is about 3.2:1, depending on practice size.

Dr. Peter Weinstein, chair of the AVMA Veterinary Economics Strategy Committee, said the document can also be used to aid veterinary practices in preparing for long-term crises. “There’s a lot of useful information in this report to help practices be in a position should a nonpandemic disaster hit their community, like a flood or a tornado,” he said.

Survey says

Dr. Michael Longoni, medical director of Diamond Veterinary Hospital in Everett, Washington, remembers well the early shock of the pandemic. He and his practice manager, Angie Koellner, were already preoccupied, going through a corporate transition, when news of COVID-19 hit. Gov. Jay Inslee started issuing directives in February and March to shut down businesses and preserve personal protective equipment.

Dr. Longoni’s clinic stopped all routine procedures, including spays, neuters, and dentals, and even cut back on vaccinations for the first two months. The clinic paused routine procedures again briefly when a second wave of COVID-19 hit following the holidays late in 2020.

The practice came close a few times but never ran out of PPE thanks to being more conservative with the number of routine procedures scheduled, once the practice was able to resume performing them.

“The hardest thing is inventory. Our inventory person knew it would be a challenge” to procure items, particularly when the price would increase 200% from when the practice last bought them, Dr. Longoni said. “In the middle of a pandemic, how do you stay price viable?”

Chart: Factors impacting practices’ monthly cash flow, April 2020
Chart: Impact of COVID-19 on revenue by primary focus of the practice, April 2020

Overall, the AVMA survey findings from April show a large number of veterinary practices had decreases in several key areas during the survey period, including client traffic, operating hours, and revenue.

Combining survey results from April and June, however, 46% of practices reported revenue increases of 1% to 25% in 2020, compared with 2019. A similar percentage of practices reported a year-over-year 1% to 25% increase in expenses. Twenty-eight percent of survey respondents experienced no change in revenue between 2019 and 2020, while 20% saw revenue drop by 1% to 25%.

Cash shortfalls—when a business’s financial obligations exceed the amount of available cash—averaged $17,000 for veterinary practices in April and $14,000 in June. In April, most practices (61%) accounted for the shortfall at least partly with loans from the Small Business Administration, but by June that number had fallen to 39%.


Today, Dr. Longoni is still worried about social distancing and keeping staff members safe. The practice had to add another overnight staff member and has sometimes stopped seeing more emergency cases until the staff catches up, except for certain critical cases.

Even now, with COVID-19 cases decreasing, Dr. Longoni is left wondering whether to start doing more again and switch back to “normal.”

“Angie and I have talked. With the volume of our practice the way it is, we are not anxious to go back to noncurbside. Even once other practices start to go back and the governor implies you can, we’re probably going to be late to that game. We had just gone through a remodel the year before, which allows for more space, but social distancing in veterinary medicine is almost an oxymoron,” he said.

Diamond Veterinary Hospital staff member escorts Trouble the dog
A veterinary staff member escorts Trouble the dog into Diamond Veterinary Hospital in Everett, Washington, which switched to curbside service early in the pandemic. (Courtesy of Dr. Michael Longoni)

Like Diamond Veterinary Hospital, many practices implemented a wide range of operational strategies and precautionary measures to continue providing veterinary care while working to limit the spread of the coronavirus.

The most common approach was asking clients to wait in their vehicles during examination and treatment of their animals. Other operational changes included contactless payment processing, taking patient histories by phone or virtually, and drive-thru pickup and drop-off.

Between April and June, a small number of practices reduced many of these approaches. For example, in April, 84% of respondents asked clients to wait in their vehicles during treatment; by June, that number dropped to 73%. The number of practices implementing contactless payment processing and taking patient histories by phone or virtually also declined during that time. In contrast, the percentage of practices taking client visits only by appointment increased from 56% in April to 75% in June.

The number of veterinary practices that reported using telemedicine in April and June remained constant at 32%. Eighteen percent of practices only saw emergency-related cases at the time of the second survey, down from 20% reported in the first survey.

Make a plan

One of the key takeaways from the AVMA report, according to Dr. Weinstein, is preparation. Every practice owner should plan for long-term emergencies.

“Make sure you have some operational funds put away, a rainy day fund that’s invested but liquid so, if for some reason you have to shut down, you can still pay your staff, your bills, and so on,” Dr. Weinstein explained.

Telemedicine and other web-based innovations, such as online pharmacies and pet food delivery, are ways a practice can continue generating income even when the building is closed, he said. And if a practice must close, the practice should keep clients updated via its website and social media.