"All of a sudden, the price just skyrocketed. You could go when it was 60 bucks. Now I can't get out for less than $150." Those are the words of a pet owner interviewed for the 2011 Bayer Veterinary Care Usage Study. Sound familiar? Our clients are complaining about price more than ever before. And they're right in thinking that fees have increased dramatically.

Let's go back a few years to look at the change. From 2004 to 2006, 76 percent of the fees in the AAHA Veterinary Fee Reference increased faster than the rate of inflation. Examples?

> More than 60 percent of anesthesia fees increased 18 percent to 31 percent.

> A surprising 60 percent of surgery fees increased—some by a whopping 61 percent.

No wonder pet owners have noticed! The rate of increase hasn't been as dramatic since the recession, but fees are still going up.

Veterinary care has gotten more expensive because of the increasingly sophisticated medical options available, along with pets' extended life span, which results in more routine care and a higher chance for chronic disease over time. What we don't know about our disgruntled pet owner above, however, is whether she received a better bundle of services and more medical value for $150 than $60. Apparently she doesn't know either. All she sees is that visiting the veterinary clinic costs more than it used to, and she's not convinced it's worth it.

Veterinary care "sticker shock" is just one of the findings from the usage study, a research initiative conducted by Bayer Animal Health, the National Commission on Veterinary Economic Issues, and Brakke Consulting. Concerned that the number of dog and cat visits to veterinarians was decreasing at the same time the pet population was increasing, the study's authors set out to measure what exactly pet owners thought about the need for veterinary services and whether pets were getting adequate care.

The study identified six key reasons that visits have been declining. Besides sticker shock, factors include the recession, the fragmentation of services, the Internet, a lack of understanding about the need for care, and feline resistance to visiting veterinarians. We explored the need for client education last month (see the results at http://dvm360.com/skipthevet), and now we're drilling into a big reason for sticker shock here: failure to communicate value.

Pinpoint your profits

Is the cost of care keeping clients away from your practice? To find out, take a close look at your hospital's operating profitability. It's the most comprehensive indicator of financial success in any small business. Unfortunately, it doesn't show up on your regular financial reports. You'll need a little help. See a veterinary financial expert or head online to the NCVEI/VetPartners Profitability Estimator at http://ncvei.org/.

Once you get the numbers, you'll see whether you're financially healthy or not. If your practice is highly profitable with growth in new clients and visits, then the fees you charge are probably fine. If your practice isn't as profitable as it could be, if you aren't attracting new clients, or if your visits and transactions are declining, pricing may be an issue for you.