The short answer
Published research most often names cost as the main barrier to veterinary care. Geography and staffing shortages follow. A Colorado survey published in 2024 found that, among a representative sample of pet owners, the lack of an available appointment was reported more often than cost. On the scheduling side, the evidence is thin. One community clinic case study describes adding walk-in slots to offset no-shows, and one 2021 trade column reports trade association survey data on deposits and no-show fees. No peer-reviewed study of veterinary appointment templates or no-show rates appears among the sources cited here.
Key takeaways
- A 2024 scoping review of 77 publications found financial limitations were the most frequently reported barrier, discussed in 57 of them [1].
- In a 2023 Colorado survey, 49.8% of online respondents who could not get care cited no available appointments at a nearby clinic, ahead of cost at 28.4% [2].
- About two-thirds of Colorado veterinarians and technicians said their clinic diverted clients at least weekly because it could not fit them in [2].
- A Phoenix clinic that moved to a single high-volume Saturday reported 55 to 70 patients per Saturday, compared with 6 to 9 per weekday under its old model [3].
- Of pet owners in the Colorado online sample, 72.5% said they were comfortable with a telemedicine appointment [2].
- In a November 2020 VHMA survey of 304 practices, about 10% required a deposit from new clients, according to a Today's Veterinary Business column [4].
Barriers reported in the literature
Pasteur and colleagues at Purdue University published a scoping review in Frontiers in Veterinary Science in 2024. They screened 1,044 publications and included 77, published between 2002 and 2022 [1]. The authors grouped the barriers they found into ten themes. The table lists the number of included publications that mentioned each theme [1].
| Barrier theme | Publications mentioning it |
|---|
| Financial limitations | 57 |
| Geographic location | 35 |
| Limited personnel/equipment | 32 |
| Transportation | 24 |
| Veterinarian-client relationship | 20 |
| Client identity | 17 |
| Appointment availability | 14 |
| Client mental/physical condition | 6 |
| Government support | 6 |
| COVID-19 pandemic | 4 |
The reviewers treated the small amount of work on appointment availability, client identity and the veterinarian-client relationship as a major gap in the literature [1]. They also reported that 87% of the included publications discussed access without defining it [1]. Their proposed definition says access means the resources people need "to secure, communicate with, and benefit from the services of a trusted veterinary service provider are available as needed" [1]. The review's methods carry limits. It covered English-language, peer-reviewed work only and excluded gray literature, and the authors note that relevant work in other languages may have been missed [1]. After an initial reliability check, one reviewer screened most titles and abstracts [1].
Appointment availability and clinic hours
Niemiec and colleagues at Colorado State University surveyed both sides of the problem in 2023 and published the results in 2024 [2]. The pet owner arm had two parts. One was a Qualtrics online panel of 919 owners, stratified to match the state on age, gender and income. The other was 290 owners surveyed in person at pet food pantry and shelter events [2].
In the online sample, 28.4% reported an unsuccessful attempt to get veterinary care in the past two years. The authors noted that this matches a prior national figure [2]. Among those owners, the reasons given were:
- no available appointments at a nearby clinic (49.8%)
- the clinic not being open when they could come (32.6%)
- being unable to afford care (28.4%) [2]
The in-person sample looked different. In that group, 82.8% of those turned away cited cost [2]. In both groups, emergency care was the type of care owners were most often seeking when they could not get it [2].
The professional survey drew 736 veterinarians, technicians and practice managers or owners, a 12.7% response rate [2]. Of practice managers and owners, 71.9% said their clinic diverted clients at least weekly because it could not schedule them or treat them in a reasonable time frame. The figure was 67.3% for veterinarians and technicians [2]. Among online owners, 69.8% rated more appointments outside the hours of 8 to 5, Monday through Friday, as very or extremely helpful [2].
The authors acknowledge possible response bias among professionals. They also cite prior work suggesting that online panel samples can be biased on animal-related topics [2]. The authors state that they did not conduct hypothesis testing and that they primarily report descriptive statistics [2].
Walk-in blocks and consolidated clinic days
A 2025 community case study describes how the Arizona Animal Welfare League (AAWL) restructured its public clinic in Phoenix [3]. Before the change, the clinic ran five days a week and saw about 6 to 9 patients a day. AAWL's own financial analysis found that model was not sustainable [3]. In March 2024 the clinic moved to Saturdays only, running from 8 a.m. to 6 p.m. Mornings were a high-volume vaccine clinic and afternoons offered 20-minute wellness appointments [3]. The authors say the change was informed by survey feedback that weekends were easier for residents. The departure of the clinic's license-holding veterinarian also forced the timing [3].
Under the new model, average volume was 55 patients per Saturday in March, 70 in April and 66 by July [3]. Staffing was one veterinarian, three technicians and one receptionist, which the authors describe as comparable to the old weekday model [3].
No-shows were a persistent problem. Booked slots went empty while other clients sat on waitlists [3]. Starting in May 2024, the clinic opened walk-in slots from 8:00 to 9:30 a.m. the window with the most no-shows, and capped them at 15 patients [3]. The authors report that the slots filled quickly and that clients arrived very early to get one. They read this as a sign of high demand and few alternatives, though they say the exact reasons cannot be determined [3]. The clinic also tried appointment reminders "to varying effects" and piloted a $5 deposit [3].
This is a descriptive, single-site account with no control group. The authors acknowledge possible cultural bias because they hold relationships within the community and have roles in the organization [3]. The clinic's 2022 needs assessment surveyed more than 600 owners. Across the 2022 and 2023 needs assessment surveys, 59.2% (336/568) of respondents said they had recently needed care and could not get it [3].
Telemedicine
In the Colorado online sample, 72.5% of owners said they were comfortable seeing a veterinarian by telemedicine [2]. Of those, 74.1% said they would be comfortable with a first visit done virtually. Overall, 64.0% said telemedicine access would somewhat or greatly increase their likelihood of contacting a veterinarian [2].
Professionals were more divided. In the professional survey, 63.4% believed expanded telemedicine would improve access for underserved populations [2]. Asked about a law allowing a veterinarian-client-patient relationship (VCPR) to be established virtually, 43% expected a positive effect on the profession, 39% a negative one, and 18% no effect [2]. The study authors reported that Arizona, Florida and California had passed laws allowing a virtual VCPR. They described AVMA policy as limiting telemedicine to an existing VCPR [2]. None of the sources cited here is a regulator's own page, so readers should check current state rules directly.
No-show deposits and fees
Karen E. Felsted, writing in Today's Veterinary Business in early 2021, reported results from a November 2020 Veterinary Hospital Managers Association survey of 304 participating practices [4]. This was a trade association survey, and the column does not describe how practices were selected or whether they represent practices generally.
According to the column, just over half of respondents saw more no-shows after the pandemic began, mostly among new clients booking a first visit [4]. About 10% regularly required a new-client deposit, and roughly two-thirds of those practices started after the pandemic [4]. Just over half set the deposit at the exam fee. In addition, 51% refunded the deposit if the client canceled more than 24 hours ahead, and 28% gave no refund [4]. Felsted reported that the "vast majority" of practices with a deposit policy saw fewer no-shows [4].
After-the-fact no-show fees were less common. About 7% charged one, and about 20% charged for cancellations with less than 24 hours' notice [4]. Client reception was split, with about 40% of practices saying clients accepted the fee and 45% saying they reacted negatively. Fewer practices credited the fee with reducing no-shows than credited deposits [4]. One manager quoted in the column said a prepayment requirement "tells them we don't trust them before we ever even meet them" [4].
Felsted wrote that the practices most successful at cutting no-shows send an electronic confirmation right after booking and then more reminders, including one within a day or so of the visit [4]. The column lists cost worries, fear of a diagnosis, transportation, forgetfulness and work as reasons owners miss appointments [4].
Our read is that the deposit figures come from veterinary practices during the COVID-19 pandemic [4]. The Phoenix clinic's choice of a $5 deposit sits alongside the Colorado finding that cost dominated among pantry and shelter clients [2][3]. The sources do not test how deposits affect access for low-income clients.
