The Cultural Difference Between Veterinary and Human Medicine
In veterinary medicine, cash payment is standard; there is no insurance intermediary, no preauthorization, and no justification for care.
Pet owners pay thousands upfront for:
Surgeries
Diagnostics
Cancer treatment
Chronic disease management
The entire system operates on transparent pricing and immediate payment.
No one questions whether it's "allowed" or "ethical," it's just how veterinary care works.
In human healthcare, we've been conditioned differently:
Insurance appears to be the only legitimate payment model.
Cash-based feels risky, unethical, or like we're abandoning people.
Practitioners fear they're doing something wrong by not taking insurance.
The system trained us to require permission, even though we never needed it.
I know what you're thinking:
"But veterinarians don't have licensing boards, same as I do.”
Not True.
Veterinarians are regulated by state veterinary medical boards, just like human healthcare practitioners.
They have:
Disciplinary processes for violations.
Continuing education requirements.
Ethical standards and codes of conduct.
Licensing requirements and examinations.
Regulations on what they can and cannot do.
They must follow the defined scope of practice.
They face the same professional oversight you do.
The difference?
Their licensing boards never conflated payment models with the scope of practice.
They regulate:
Diagnoses they can make.
Procedures they can perform.
Medications they can prescribe.
The standards of care that must be met.
They don't regulate:
How much veterinarians can charge.
Whether veterinarians can accept cash payment.
Whether clients (and pets) need insurance to receive care.
This proves a critical point:
Professional regulation and cash-based payment are completely separate systems.
Your licensing board cares about whether you're practicing within your scope, not whether insurance companies are involved in the transaction.
Veterinary medicine has maintained this distinction for decades. Human healthcare can too.
Insurance billing rules are separate and defined very differently from professional practice standards.
You're allowed to practice within your scope AND get paid directly by clients. These aren't in conflict.
Why People Pay Differently for Pets vs. Themselves
The truth: People will pay $5,000 for their dog's ACL surgery without hesitation. I have observed this repeatedly when I worked in veterinary hospitals and clinics.
When it comes to their own wellness, chronic care, or preventative support:
"Can insurance cover this?"
"What if I can't afford it?"
"Is this really necessary?"
This isn't about capacity, it's about conditioning.
We've been taught:
Our health is an insurer's responsibility.
We should only pay when the insurance covers it.
Investing in ourselves is optional, but investing in pets is worthwhile.
Here's what I've seen working with clinicians who made this transition
One practitioner left an insurance-based clinic and started her own cash-based practice. She was terrified no one would pay.
Her patient calendar is filled.
Why? Because her patients wanted:
More quality care.
More time with her as their practitioner.
To feel seen, not like another "number" in a medical system.
They paid in cash because it was the same amount as their deductible, and now they have 60-minute appointments instead of 15-minute rushes.
The real pattern:
When trust exists, people invest.
People pay for quality care; they always have.
When something is valued, people find the money.
When care is framed clearly, payment becomes simple.
What This Reveals About Conditioning, Not Capacity
You might be thinking:
"People expect insurance for human healthcare. My situation is different."
Let me ask you this: Do people expect insurance to cover:
Dentistry? (Many pay cash)
Acupuncture? (Mostly cash-based)
Massage therapy? (Cash-based)
Mental health therapy? (Many therapists are out-of-network)
Functional medicine? (Largely cash-based)
Cash-based healthcare has existed for decades and continues to thrive.
The insurance system benefits when you believe:
Cash-based practices are risky or unregulated.
Clients won't pay without insurance backing you.
You need their approval to receive or provide care.
You can't build a legitimate business without being in-network.
None of this is true.
Regulations never blocked us. The insurance system was created by fear to keep us dependent.
The Insurance Reframe That Changes Everything
Think of insurance like car insurance:
Car insurance covers:
Accidents
Major damage
Emergencies
Car insurance does NOT cover:
Oil changes
Tire rotations
Car washes
Routine maintenance
You don't call your car insurance company to pay for an oil change.
So why do we think health insurance should cover:
Lifestyle coaching
Proactive support
Preventative wellness
Chronic care management
Transformational healing work
Insurance was designed for emergencies, not maintenance.
Cash-based care is:
Proactive, not reactive
Intentional, not transactional
Client-centered, not system-compliant
Sustainable for both practitioner and client
"But what do I even charge? How do I structure payments?"
This is where most practitioners get stuck, not because it's complicated, but because the insurance system never taught you to value your own time.
The answer starts with clarity:
What transformation are you creating?
What would enable you to be fully present?
How much time does quality care actually require?
Pricing isn't about what insurance would pay. It's about what your expertise, time, and presence are worth.
And yes, there's a straightforward process for determining this; you don't have to guess.
What This Means for You
If you're a healthcare practitioner ready to build a cash-based practice:
You don't need permission
Cash-based practices are legal, ethical, and common.
Veterinary medicine proves this model works at scale.
Insurance billing rules are not the same as professional standards.
Your licensing board regulates the scope of practice, not payment models.
You don't need to fear it
People already pay cash for services they value.
The insurance system created this fear to keep you dependent.
Quality care attracts paying clients, I've seen it happen again and again.
You can trust yourself
Once you believe in your value, clients feel it.
When you communicate clearly, people invest.
The mechanics are simple once the internal work is done.
"This sounds possible... but I still don't know HOW to do it for MY license, MY state, MY specific situation."
That's precisely the work I do.
I've guided licensed therapists, nurses, allied health professionals, and holistic practitioners through this exact transition, helping them:
Understand their scope within a cash-based model.
Build practices filled with people who prioritize quality, not just coverage.
Communicate value clearly so clients understand what they're paying for.
Establish their business structure in accordance with their license and state requirements.
You don't have to figure this out alone. And you don't have to choose between doing it right and doing it scared.
The bottom line:
Cash-based wellness practices are neither new, risky, nor unethical. They've been here all along, thriving outside the insurance system in industries that never bought into the fear.
Your fears are valid. The path forward is real. And you're not doing this alone.
You're not breaking rules. You're stepping into freedom that was always available.
Ready to build a cash-based practice with clarity and confidence? Let's simplify the path forward together.
With Clarity and Simplicity,
Suzy Wraines, Healing-Centered Business Coach