Is the AVMA listening?

During the annual convention in Atlanta, AVMA members were invited to attend two town hall meetings to discuss issues and concerns that were on their minds. The interactive discussion was led by a facilitator to ensure that the greatest benefit would be gained from the discourse. The town hall meetings are just one new channel of communication the Association has opened to elicit member input, along with recent online tools, more of which are planned when the AVMA website is redesigned.

Although a limited number of AVMA members found time to attend, those members who did attend raised a number of interesting questions, and, during the discussion, offered relevant feedback on how their needs could be better met.

The following four composite questions are representative of those asked by attendees, and of the dialogue that followed.

What is the AVMA's current position on accreditation of foreign veterinary schools, and why?

Executive Board member Janver D. Krehbiel, who served on the AVMA Council on Education for six years, explained that in part, the interest in accrediting foreign veterinary schools first came from foreign students who had studied in the United States.

"They went home and talked to their faculty and deans and said the education program in the U.S. is pretty good and we think we ought to explore it further. Accreditation of foreign schools is something the COE responded to," he said.

Starting in the '90s, the council was asked by foreign veterinary schools to review their educational programs and evaluate facilities. These institutions recognized that the United States maintains a high standard of quality in its schools and evaluation process, Dr. Krehbiel said, and they wanted to benchmark themselves against the U.S. education and accreditation process.

"We felt it appropriate to respond. We had the time from the standpoint of members of the COE, and the cost was borne by those schools," Dr. Krehbiel said.

In addition, as the largest national veterinary medical association in the world, the AVMA wanted to respond positively to invitations by international veterinary colleges to participate in providing expertise.

Dr. Krehbiel also pointed out that given the shrinking global community, veterinarians have an interest in better understanding zoonotic diseases and how they come about. Food safety and world trade issues factor into this as well. Accrediting foreign schools, then, allows the AVMA to be part of these conversations on a greater scale.

"We're looking at 'one health,' and we're not unique in that. Other groups are recognizing that's important," Dr. Krehbiel said. "There's an exchanging of ideas as part of these site visits, too, becoming more familiar with one another to assist in the care of animal and human health."

A participant expressed concern that graduates of Mexican schools, one of which has applied for COE accreditation, would immigrate to the U.S. and take practitioners' jobs.

Dr. Ron DeHaven, AVMA CEO, responded, "Not to ignore the potential economic impact on graduates of domestic schools, but we can't ignore the population becoming increasingly Hispanic, and we don't have a domestic workforce to address that. You can't say increasing diversity is going to be a negative thing."

He also mentioned there are efforts to create international accreditation standards and that the AVMA would rather help create the standards than respond to ones with which it may not agree.

The AVMA, too, does not want a situation where it would be compelled to allow veterinarians into the United States who don't meet current standards, said Dr. Clark K. Fobian, District VII representative, because it would dilute the value of a veterinary degree from an AVMA-accredited institution.

"There is this illusion of a mass exodus to the U.S. from Mexico. The individuals going to (the National Autonomous University of Mexico) are not those with a strong propensity to immigrate to the U.S. They are the ones shaping and building that country," Dr. Fobian said. "Even if a certain percentage come to the U.S., they would have to do that in full compliance with immigration regulations. They would then still have to pass the national board and then be subject to state requirements that deal with licensure. If there are not appropriate regulations in effect there to indicate the quality of veterinarians coming into these states, that is where the system might have its weakest component, not at the academic level by accrediting these foreign colleges."

What is the AVMA doing to help develop our young and middle-aged leadership?

Executive Board Chair John R. Brooks acknowledged that a "sophomore jinx" can occur when the Association's opportunities for students and recent graduates no longer apply to older practitioners.

That's not to say they still can't stay involved with the AVMA. He said the Association is more actively and aggressively looking at how best to use its resources to engage and maintain involvement of young veterinarians and help them to become AVMA leaders.

The Task Force on AVMA Programs for Students and Recent Graduates is one example. Dr. Joseph H. Kinnarney, who chairs the task force, said the question came up at the task force's first meeting: How do we reach the segment of veterinarians who have graduated years ago? The task force is still searching for a definitive answer and welcomes input from all members, he said.

A midcareer veterinarian looking to become involved in organized veterinary medicine may want to start at the state level, Dr. Kinnarney said.

"I had someone take me to a (state VMA) meeting, and that was that. If someone is not reaching out to you, reach out to someone to take you to a meeting. It's all about mentorship," he said.

The AVMA helps to foster some of these volunteers at its Veterinary Leadership Conference every January. Current and future leaders of the Association gather to attend educational sessions, listen to experts discussing veterinary and leadership issues, and learn more about the AVMA. The annual forum enhances the leadership, governance, and public relations skills of state and allied organization leaders, CEOs, and recent graduates.

Once someone is ready to volunteer with the AVMA, Dr. John R. Scamahorn, District VI representative, said a great way to get involved is serving on a task force.

"We have two task forces right now where we're looking for volunteers. It's a short commitment, so it doesn't tie you up," he said.

In all, the AVMA has six standing councils, 24 committees, and six task forces. Dr. DeHaven said members can get involved without devoting a substantial amount of time.

"While many of our volunteers come up through state organizations, there's no requirement that you have to in order to serve with the AVMA," he said.

He added, "We want to be a member-driven organization and we're doing a lot to help that two-way communication. It's just a matter of educating everybody to all the ways we can have the two-way commitment."

Dr. DeHaven lamented the fact that few regular AVMA members turned out for the AVMA Live sessions.

"We have lots of leaders here because we're interested in hearing what you want to say … and want to incorporate those thoughts into all the things we're involved with," he said.

Why isn't my input sought on policy issues, and why isn't the AVMA more visible as a leader?

Does the AVMA send too little, too much, or about the right amount of information to its members? In general, AVMA Live attendees agreed that the amount of communication they were receiving or had access to is "about right," but they had much to say about the platforms.

"There is a lot of power at the district level," said a member, who suggested that organizing the AVMA website by Executive Board districts—a smaller subset of the AVMA—"would foster community."

"In my age group, we're pressed for time," a young member noted, urging more use of Facebook, which she said is "wicked-easy."

An attendee said it is curious that the AVMA website does not ask for member input. However, staff attending the session underscored a number of areas that do ask, including the NOAH discussion board; the AVMA@Work blog, where members can post and respond to specific topics; and environmental scanning, which solicits member input on critical issues facing the profession.

Also, this summer the AVMA launched an online tool through which members can provide direct input that will help shape the Association's animal welfare policies.

Dr. Michael Blackwell, Knoxville, Tenn., questioned why members are not polled before an AVMA position is taken to Washington. "As a member, to never be asked on a key issue makes me wonder if I really have representation," he said.

AVMA governance is representative, noted Dr. Douglas G. Aspros, 2006-2010 District I board member, and decisions aren't made by polling or a "simple majority" of members. AVMA policies aren't developed merely to reflect the opinions of members but also their long-term interests as veterinary professionals. In formulating a policy, the AVMA sometimes adopts a "representative perspective," he said, and other times, an expert perspective. He added, "If we ask a question and 500 members answer, that (response) may not be representative" of the point of view of the broader membership. "We would listen, but that may not be the (final) basis for the policy."

AVMA CEO Dr. Ron DeHaven said, "We need better communication on policy issues—Dr. Blackwell made that point well. He and I were both from the federal government, and they use the Federal Register, then share comments and their responses. We're testing the waters with (the online animal welfare tool) and could extend that to other areas. "

Attendees were told the AVMA website redevelopment will greatly enhance the ability to reach out for member input. The Executive Board has earmarked $1 million for this overhaul. In September, a contract was signed with a technology partner for the project.

A few attendees contended the AVMA is not viewed as a leader. Dr. Blackwell, who is president of a leadership recruitment firm, said the Association isn't often quoted or the go-to resource. He believes the AVMA has an image problem and said a key example is that the AVMA testifies at congressional hearings alongside agriculture representatives rather than other medical and public health professionals.

In answer, Dr. Gail C. Golab, director of the Animal Welfare Division, said that public visibility and influence are both important but not necessarily identical. Influence is as much about establishing trust and consistency as it is about public visibility. The AVMA disseminates information strategically, sits on key entities, is involved in science and public policy forums, and is an intermediary that gets divergent groups talking.

Relative to hearings on the Hill, it was clarified that the congressional committees, not AVMA, decide on the order in which speakers will testify.

Besides addressing the perception issue, an attendee urged stronger, follow-through leadership. She said, "Take a position, advocate for it, and lead on it."

Have you considered publishing the Journal of the American Veterinary Medical Association online only?

Dr. Kurt J. Matushek, AVMA editor-in-chief and director of the Publications Division, said he hears this question periodically. The AVMA has conducted a readership survey every three years for the past 12 to 15 years. The most recent survey, in 2009, asked participants to indicate how interested they would be in having the JAVMA provide online-only subscriptions on a scale from 1, meaning not at all interested, to 5, meaning very interested. A majority said they were not interested in online-only subscriptions, with 44 percent of respondents giving 1 as their answer. The 2009 results did not deviate much from those of the 2006 survey.

"There are some who would definitely like it that way, but not a majority," Dr. Matushek said. "Some say we'd save money not printing the Journal. With postage and paper and printing, it costs us a little less than $2 million a year, but our classified and display income comes to just over $2 million. Were we to drop the print journal, that would go away completely."

The editor-in-chief pointed to the Journal of the American Animal Hospital Association's recent reversal of its decision to go online only (see JAVMA, Aug. 1, 2010). It will start printing its journal again in January. "We still think there is a large segment of veterinarians looking for print journals," Dr. Matushek said. "New media don't necessarily replace old media. TV didn't replace radio. These are not substitutes for each other; they complement each other. People use different media all at the same time, so I don't think we'll go online only in the near future."

A young woman in the audience then asked whether the American Journal of Veterinary Research would ever go online only. Dr. Matushek replied that though JAVMA readership is different from that of AJVR—with 75,000 circulation compared with 6,500—there is still a strong archival reason to print even the latter.

"People continue to cite our journals. The Institute for Scientific Information says more than half of all AJVR articles cited in the literature are more than 10 years old," he said, further indicating how important retrievability remains for the publication.