I don't know if it was said on the show or something I read outside of it, but Dr. Jeff has said that many, if not all, of the spay and neuter clinics are funded by the ASPCA and/or The Humane Society(ies) and his time is the only thing he donates. The drugs needed to anesthetize are expensive, and there is usually a donation of some kind to the buildings they use. He did say on the show that he is comfortable and his kids are comfortable so he doesn't need a large salary, which is admirable.
He also employs veterinarian students who are at the place in their careers to get practical experience, and many of the services offered at low cost are performed by them with a more experienced vet assisting. I'd imagine that they are less expensive to employ, but of course, can't say for sure.
That said, to take a situation that appeared on the show and apply it to me, if my dog got out and was hit by a car and I took him to my regular vet and he told me that his leg needed amputated and it would cost $4000 OR I could euthanize him OR I could go to Planned Pethood for a second opinion and lower cost options and that office quoted me $600 to $800 with the surgery being performed after a $300 down-payment and payment arrangements for the rest, my vet just lost out on the $800 and my future business. It's possible that the fees are waived or further reduced by the production team, and they are just saying that they were referred, but it just seems to be a regular occurrence on this show.
Having to euthanize a pet that is ill with a low quality of life is a horrible feeling. Having to euthanize a pet that was injured in an accident because you couldn't afford treatment and that treatment would allow a long life if performed would be absolutely crushing. Dr. Jeff has taken the position that he won't allow an animal to suffer or be put down just on the basis of money, and has organized his practice to allow that. The vet that will only treat the animal for $4000 has made a different decision for their business, and while it is his or her right, that person would not be the vet for me.
In real life, my vet bills insurance companies and his commercial farm clients full price, and offers low cost services when needed. He operates on a sliding scale, which may be regional because my medical doctor also has a sliding scale, as does my dentist and my son's ophthalmologist.
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