Dr. Bill Wagner
Where Have All the Veterinarians Gone? Part 2 of 2: Finding Answers
In our last blog post, I discussed the acute and growing crisis of access to veterinary care in the United States.
As your vet partner, in my opinion the profession’s response so far to this crisis has been “too little, too late”. Given the significant lead time that it takes to expand the veterinarian workforce, the recent efforts to increase the number of accredited veterinary medical schools and increase class sizes at existing schools will not provide relief to this crisis for many years to come and in the meantime the problem will continue to get worse before it gets better. So, considering that (a bit grim) outlook, what can be done?
There are two ways in which we must think to tackle the veterinarian shortage: profession-wide and practice-level.
Profession-wide solutions will require the institutions of veterinary medicine, particularly the AVMA Council on Education and AVMA Committee on Veterinary Technician Education and Activities, to acknowledge the gravity of the veterinarian and veterinary technician shortage and attack it with a greater sense of urgency.
The verdict has been definitively in for nearly a decade that the demand for veterinary services is rising, with sustainable generational tailwinds supporting continued growth. This isn’t just a one-off phenomenon of “COVID puppies”.
However, even as recently as 2019 and again in 2021 the AVMA failed to definitively say that a shortage even exists in direct contradiction of data from the Bureau of Labor Statistics and other independent sources pointing towards an alarming and growing shortage of veterinarians.
The veterinarian shortage is causing clear harm. Pets are not receiving the care that they need, owners are growing frustrated with care access issues, and veterinarians are shouldering the brunt of this crisis. The reputation of the profession is in danger.
As the primary advocacy organization of the profession, there is no issue that is more important for the AVMA to be focusing on. The AVMA is seemingly only now reaching the point of even admitting that the problem exists. Increasing the number of annual AVMA accredited veterinary medical school seats and reducing cost of education are of paramount importance, and unfortunately a process that has an extremely long lead time and we are well behind already. One temporary band-aid measure that the AVMA can explore is pushing state boards to adopt a universal national license reciprocity program. Universal national licensing would increase mobility of vets, allowing labor to slide to areas of most acute shortage more easily. Increasing the support for foreign graduates to achieve licensure in the US would also allow the US veterinary market to expand the access to skilled labor. Standards should remain high for licensure of individuals from non-accredited programs to ensure clinical competency, but it behooves the profession to ensure that barriers including the significant cost is mitigated.
As discussed in part 1 of this article, it is this author’s opinion that the creation of a paraprofessional job class in veterinary medicine is not the right answer to the veterinarian shortage.
Instead, we should elevate credentialed veterinary technicians to the level of being true veterinary nurses, as they are capable of being. Fully utilizing skilled nursing staff leverage properly trained veterinarian providers ensures that we do not compromise quality of care with a misguided “band aid” by creating an underqualified provider class.
An important step forward for improving credentialed technician leverage across the profession would be a unification of standards across state practice acts of what credentialed technicians can do independently, under direct veterinarian supervision, and what non-credentialed team members can do under direct supervision by a credentialed technician.
Increasing the role of veterinary technicians in the delivery of veterinary healthcare, with reasonable understanding of which tasks in the veterinary hospital need to remain provider-only, creates a path to delivering more care per DVM in the workforce.
Additionally, this creates a stronger basis for CVT compensation to grow, supporting longer and more rewarding careers for technicians.
Institutional solutions for the veterinarian shortage will take many years to catch up with demand due to the long lead time of training new veterinarians. In the meantime, veterinary practices will need to continue to seek innovation on how to best utilize the time and energy of the veterinarians currently in the workforce without burning them out.
Let’s discuss a few examples of practice-level thinking to combat this situation.
“Leverage” has become the buzzword in contemporary veterinary practice management. Leverage is a great word for it: Imagine using a longer lever arm to turn the same amount of work into a greater applied force, like a car jack. Chances are you can’t lift a car with your bare hands, but with the right tool you can leverage your own strength into a super-human outcome. Having the right people on your team, enough people, and giving those people the right tools to succeed with are the keys to ensuring that your veterinarians are well leveraged.
A well leveraged team is one where everyone has a clear role for which they have been properly trained, and they have the resources at their disposal to fulfill their role effectively and efficiently.
Technology can be a powerful lever, if applied correctly. New tools like telehealth, online client education resources, dictation software or remote scribes, online pharmacies, client self-service apps, inventory management programs, and more can be utilized to ensure that your team spend as much time as possible on direct patient care and client service.
Credentialed veterinary technicians who have been empowered and entrusted to work at the top of their credentials are the core of a well-leveraged veterinary team.
Burnout prevention is also a critical part of creating a well-leveraged team. The goal of proper leverage is to get more done with the same amount of effort, not to ask teams already giving 100% effort to work harder. It is critical to establish strong boundaries to protect teams from abusive clients, embrace flexible/non-traditional schedules that promote employee wellbeing, and for local leaders to constantly be actively listening to their team and acting on their feedback.
Consolidation and a hub-and-spoke practice model can significantly amplify access to veterinary services in the rural communities that are most deeply affected by the shortage of veterinarians.
Are you interested in finding out more about how your practice would benefit from becoming an AVP partner clinic, or interested in building a career at an AVP partner practice as a veterinarian, technician, assistant, or CSR? Please reach out to me at firstname.lastname@example.org to learn more.
Your vet partner,