Content note: This episode discusses veterinary suicide and includes a provider's personal disclosure about a mental health crisis. If this episode brought up anything hard for you: 988 Suicide & Crisis Lifeline (call or text 988) · Not One More Vet — https://www.nomv.org/ U.S. veterinary care access crisis driven by affordability, geography, and identity-based barriers: as of 2026, over 23 million pets live in households unable to pay for veterinary care, veterinary service prices are up 48.8% since 2019, and the USDA has identified 243 rural veterinarian shortages across 46 states. It argues that blaming low-income pet owners or individual veterinarians ("if you can't afford the vet, you can't afford the pet") ignores systemic issues, including lack of social safety nets and rising costs, and notes limited financing options like CareCredit and low insurance impact (only 2% of vet bills paid by insurance). The conversation links vet deserts to other community "deserts," highlights language and racial inequities (e.g., few Spanish-speaking clinics), describes shelter surrender patterns and animal-control over-enforcement, and emphasizes severe provider mental health impacts, including elevated suicide risk, burnout, and moral distress from euthanasia and isolation. 00:00 Vet Care Crisis Overview 01:02 Blame and Poverty Narrative 03:31 Systemic Economics and Costs 05:27 Provider Burnout Reality 09:52 Symptoms Versus Disease 10:44 Affordability Breakdown 13:42 Real World Cost Stories 18:03 Payment Plans and Credit 21:42 Corporate Clinics and Debt 24:32 Mapping Vet Deserts 29:22 Telemedicine Limits 35:40 Identity and Language Barriers 40:18 Pet Insurance Reality Check 47:08 Shelter Pipeline Pressure 48:40 Ethics and Euthanasia 50:33 Vet Suicide Crisis 53:17 Animal Control Bias 56:23 Deserts and Distress 01:06:49 Burnout Turnover Loop 01:14:11 Online Reviews Trauma 01:24:48 Teaching Mental Health 01:30:29 Practical Care Advice 01:37:34 Compassionate Closing Content note: This episode discusses veterinary suicide and includes a provider's personal disclosure about a mental health crisis. If this episode brought up anything hard for you: 988 Suicide & Crisis Lifeline (call or text 988) · Not One More Vet — https://www.nomv.org/ Sources & Further Reading Diana A, Croney C, et al. "Access to veterinary care: evaluating working definitions, barriers, and implications for animal welfare." Frontiers in Veterinary Science, 2024;11:1335410. https://doi.org/10.3389/fvets.2024.1335410 Program for Pet Health Equity / Maddie's Fund. 2025 national update on access to veterinary care. https://ppheequity.org/ Greenberg SA, Neal PR. Veterinary Care Accessibility Score (VCAS), 2022. https://vcap.indexys.co/ U.S. Bureau of Labor Statistics. Consumer Price Index, veterinary services vs. all-items CPI-U, 2019–2025. https://www.bls.gov/cpi/ USDA National Institute of Food and Agriculture. Veterinary Services Shortage Situations, 2025. https://www.nifa.usda.gov/vmlrp-map American Veterinary Medical Association. U.S. veterinary workforce market research, 2024. https://www.avma.org/news/usda-announces-plan-address-rural-federal-veterinary-shortages Weisent J, Debolt R, Daugherty LM, Niceley A, Norris JL. "Assessing the veterinary health care needs of Knoxville's Latino community." Journal of Shelter Medicine and Community Animal Health, 2024;3(1). https://doi.org/10.56771/jsmcah.v3.78 Landau RE, Beck A, Glickman LT, Litster A, Widmar NJO, Moore GE. "Preparedness of small animal veterinary practices to communicate with Spanish-speaking pet owners." J Am Vet Med Assoc, 2016;248(6):690–699. https://pubmed.ncbi.nlm.nih.gov/26953924/ Park RM, Gruen ME, Royal K. "Association between dog owner demographics and willingness to seek veterinary care." Veterinary Sciences, 2021;8(1):7. https://doi.org/10.3390/vetsci8010007 Hawes SM, Hupe T, Morris KN. "Punishment to support: the need to align animal control enforcement with the human social justice movement." Animals, 2020;10(10):1902. https://doi.org/10.3390/ani10101902 (Pets for Life cost figures via HSUS: https://humanepro.org/programs/pets-for-life) Ly LH, Gordon E, Protopopova A. "Inequitable flow of animals in and out of shelters: community-level vulnerability of owner-surrendered and adopted animals." Frontiers in Veterinary Science, 2021;8:784389. https://pmc.ncbi.nlm.nih.gov/articles/PMC8635993/ (Canadian shelter dataset) Tomasi SE, Fechter-Leggett ED, Edwards NT, Reddish AD, Crosby AE, Nett RJ. "Suicide among veterinarians in the United States from 1979 through 2015." J Am Vet Med Assoc, 2019;254(1):104–112. Free author manuscript: https://pmc.ncbi.nlm.nih.gov/articles/PMC6417412/ Volk JO, et al. Merck Animal Health Veterinarian Wellbeing Study III and Veterinary Support Staff Study. J Am Vet Med Assoc, 2022;260(12):1547–1553. https://pubmed.ncbi.nlm.nih.gov/35943942/ Kipperman BS, Kass PH, Rishniw M. "Factors that influence small animal veterinarians' opinions and actions regarding cost of care and effects of economic limitations." J Vet Intern Med, 2018. Cited via research brief: https://ppheequity.org/ Labreque et al., 2025 (Canadian Veterinary Journal); Neill et al., 2022; Winter et al., 2023 — provider economics and food-animal-practitioner PTSD. https://www.canadianveterinarians.net/ Peterson MC, Holbrook JH, Von Hales D, Smith NL, Staker LV. "Contributions of the history, physical examination, and laboratory investigation in making medical diagnoses." Western Journal of Medicine, 1992;156(2):163–165. https://pmc.ncbi.nlm.nih.gov/articles/PMC1003190/ U.S. Census Bureau (Burns K, Fox L, Wilson D). "Expansions to the Child Tax Credit contributed to a 46% decline in child poverty since 2020." America Counts, 2022. https://www.census.gov/library/stories/2022/09/record-drop-in-child-poverty.html Centers for Disease Control and Prevention. "About One Health." CDC, 2023. https://www.cdc.gov/one-health/about/index.html