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Access to Veterinary Care Coalition

Access to Veterinary Care Coalition (AVCC)

There are more than an estimated 23 million pets living with families that cannot financially provide for their veterinary care. When these pets become ill or get injured, their families have limited options to help them. Their unmet needs mean unnecessary morbidity and mortality, and an unacceptable threat to public health.

Private veterinary practitioners are well known for “giving away” their services to help animals that would otherwise suffer or worse yet be euthanized. However, understandably, their business bottom line dictates limits on pro bono services. Some veterinarians have created more structured ways to help the underserved, such as establishing foundations to help fund medical services.

In response, some veterinarians are promoting the passage of new laws intended to protect their market. Such legislation is directed at nonprofit veterinary service providers, with the intent of limiting whom they can serve and what services are permitted. Also, some proposed legislation increases the regulatory burden on the veterinarians working with nonprofits.

Clearly, there is a need for reliable information, including: 1) how many pet owners who can pay for private veterinary services instead utilize nonprofits; and to what extent, 2) how many, if any, private veterinary practices have been negatively affected financially due to services being provided by a nonprofit service provider, and 3) what constitutes “inability to pay”; is it just those in abject poverty, or does it include middle-class families temporarily in financial difficulty at the time veterinary services are needed (e.g., due to illness, injury, or loss of job).

The for-profit private veterinary practice industry is still based largely on a “fee for service, cash only” model, with billings involving insurance at 2% or less. Consequently, these businesses rely on a robust economy with a thriving middle-class. However, since the 2008 recession, the economy continues to struggle, in particular, household income. Yet, the costs of becoming a veterinarian and providing services continue to increase, as does the number of private veterinary practitioners.

Mother and daughter talking with their dog's veterinarian

The Access to Veterinary Care Coalition (AVCC) was formed in early 2016 to draw attention to the problem of lack of access to veterinary care and to educate the veterinary profession and communities about it. It is an American story that affects millions of pets and their people in the United States. A better understanding of this societal problem will encourage evidence-based strategies to save lives.


The AVCC worked in association with the University of Tennessee Colleges of Social Work and the College of Veterinary Medicine, to conduct a national study (made possible by the generosity of Maddie’s Fund®) of pet families, including populations with inadequate access to veterinary care, and veterinary service providers. The purpose of the study was to identify barriers that households face, as well as best practices among those delivering veterinary care to underserved pet families. The results were published in 2018, Access to Veterinary Care: Barriers, Current Practices, and Public Policy. It has been widely disseminated to help guide veterinarians, animal welfare organizations, legislators, community leaders, and others as they seek to improve access to veterinary care for pets currently without it.

The primary goals of the AVCC were:

  1. Foster development and promotion of methods for providing access to veterinary care for the millions of pets currently without it.
  2. Respond to legislative, regulatory and other efforts designed to interfere with nonprofit practices’ ability to serve pet owners, and work to preempt and avoid such action whenever possible.
  3. Improve collaboration among private for-profit and nonprofit veterinary service providers as well as relevant social services providers to promote access to veterinary care for all pet owners.
  4. Provide guidance to the veterinary profession regarding ways it can help promote access to veterinary care for all pet owners.

Various disciplines were represented on the AVCC, including:

  1. Nonprofit veterinary service providers
  2. For-profit veterinary service providers
  3. National professional veterinary organizations
  4. Pet owners needing access to veterinary care
  5. Animal protection organizations
  6. Veterinary schools
  7. Veterinary social work
  8. Other animal care professionals


These original AVCC members, included:

Anne Bayer, DVMMichael Blackwell, DVM, MPHTed Cohn, DVM, AVES (Hon)
T’ FisherBrian Forsgren, DVMInga Fricke, CAWA
William Gilles, DVMLisa Greenhill, MPA, EdDLaura Helmueller, DVM
Cristie Kamiya, DVM, MBASusan Krebsbach, DVMRachael Kreisler, VMD MSCE
Sarina Manifold, LCSWMichael R. Moyer, VMDAkshay Verma


Today’s AVCC members are:

Michael Blackwell, DVM, MPHTed Cohn, DVM, AVES (Hon)Inga Fricke, CAWA
Lisa Greenhill, MPA, EdDAdrian HochstadtKendall Houlihan, DVM
Sohaila Jafarian, DVM, MPHCristie Kamiya, DVM, MBARachael Kreisler, VMD, MSCE, DACVPM (Epi)
Sarina Manifold, LCSWShaelyn St. Onge-Cole