148: Is the Veterinary Business Model Failing Our Patients? A Frontline Perspective From a Top UK Charity. With Dr Paul Manktelow
“If you can’t afford a pet, you shouldn’t own one.”
Ever said this line?
Once you’ve been on the receiving of someone’s anger about the cost of their vet bill, it’s an easy thought to have.
But it’s not the whole story, is it?
In this episode, I sit down with Dr. Paul Manktelow - a veterinary surgeon with 20+ years in UK animal charities and current Director of Veterinary Services at Blue Cross. Dr Paul shares lessons learned in not-for-profit vet care to help us untangle that tension between care, compassion, and commercial reality.
We cover:
- Trends from the front lines in the charity sector
- How “affordability” is shifting under rising cost of living
- Decision-making tools that balance optimal vs achievable care
- Business models that either enable or block access to care
- How vets can approach financial conversations with clarity, dignity, and trust
You’ll learn about:
💡 “Pragmatic care” as the antidote to chasing the mythical ‘gold standard’
💡 Cost-based vs value-based pricing models
💡How to think in tiers of care—and where the limits lie
Because behind every clinical decision is a human one.
Find out how we can help you build you in your vet career at thevetvault.com.
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Topics and Time Stamps
03:11 Balancing Costs and Care in Veterinary Practice
06:45 Challenges and Changes in the Veterinary Profession
11:41 Client Expectations vs Financial Realities
16:32 The Impact of Economic Hardships on Pet Care
32:16 Blue Cross's Model
39:10 Individual Responsibility in Veterinary Practice
42:54 Getting Clear on Quality of Life and Prognosis
47:23 Cost-Based vs Value-Based Pricing Models
01:10:05 Pragmatic Care and Clinical Guidelines
01:16:54 The One Question
