June 01, 2013

 

 Stakeholders respond to AVMA workforce study

 AAHA, AAVMC, AAEP, AABP, AASV, SAVMA comment on excess capacity finding

 
Posted on April 23, 2013
in advance of the June 1, 2013 issue of JAVMA
 

 

American Animal Hospital Association Executive Director Michael Cavanaugh says the U.S. Veterinary Workforce Study confirms what many in the veterinary profession suspected: There is no shortage of veterinarians.

The AVMA report estimates demand for veterinary services in 2012 was sufficient to fully employ 78,950 of the 90,200 veterinarians, creating an excess capacity of 12.5 percent, or the equivalent of 11,250 veterinarians.

“The study results are concerning and should end any arguments relating to a shortage of veterinarians,” Dr. Cavanaugh said.  The AAHA was one of several veterinary stakeholders that responded to the AVMA report, released April 23. If current conditions remain unchanged, the study projects U.S. veterinary service capacity will be underutilized by 11 to 14 percent through 2025, which equates to an underemployment of up to 12,300 veterinarians each year.

“Those in veterinary medicine need to stop and take a hard look at the causes of the current situation and reassess whether an increasing number of veterinarians in a market where supply far outpaces demand is in the best interests of students, the public, and our profession,” Dr. Cavanaugh said.

The Association of American Veterinary Medical Colleges describes the AVMA workforce study as “an important step among many taken in recent years to help the veterinary medical profession achieve a more appropriate state of economic equilibrium.”

Several U.S. veterinary schools expanded class sizes at a time of stagnating veterinary incomes and decreased productivity, fueling complaints the institutions were contributing to the overcapacity in the workforce.

AAVMC Executive Director Andrew Maccabe says schools were responding to a perceived public need, how­­ever. During the past decade, veterinary services in certain sectors were expected to fall alarmingly low. Efforts at increasing service capacity included expanding veterinary student enrollment, offering student loan repayment programs in exchange for working in underserviced areas, and expanding public health and biomedical research programs at veterinary schools through federal legislation, Dr. Maccabe explained.

There is no governing authority dictating U.S. veterinary school closures or class sizes, Dr. Maccabe noted. “Colleges of veterinary medicine make individual decisions regarding class size based upon their mission and the population they serve,” he said.

“Enrollment patterns are not coordinated or mediated by any agency or organization.”

For AAVMC President Deborah Kochevar, the AVMA workforce study raises an important question: How should veterinary schools and colleges respond?

“We view academic veterinary medicine and the nation’s practice environment as fully integrated, constantly interacting, and  co-dependent systems. As such, we shoulder the burdens—and the triumphs—of this profession together,” said Dr. Kochevar, dean of the Cummings School of Veterinary Medicine at Tufts University.In the coming months, AAVMC members will consider the report and its implications, association officials said, with an expectation of developing programs addressing the economic well-being of the profession and working with veterinary stakeholders to effect positive changes.

Increasing the demand for veterinary services is a key component of solving the problem of excess capacity, according to the AAVMC. “Broader public understanding of the importance of preventive health care for companion animal care should expand markets,” Dr. Kochevar said, citing the importance of the Partners for Healthy Pets initiative and similar programs.

The AVMA’s veterinary workforce study found excess capacity highest among equine practices. “The horse industry has contracted in the last five years, so the findings regarding equine practice are not surprising,” American Association of Equine Practitioners President Ann Dwyer said.

“Through our long-range strategic planning process, the AAEP is focused on providing modern veterinary serv­ice models that expand the capacity of member practices while strengthening the relationship that horse owners have with their veterinarian,” Dr. Dwyer added.

Excess capacity in the food animal sector was estimated at 15 percent—lower than the equine (23 percent) and small animal (18 percent) sectors.

The American Association of Bovine Practitioners has been studying supply and demand in food animal and mixed animal practices for the past three years. “The finding that there will be double-digit underutilization of veterinary services over the next decade supports what the AABP ad hoc rural veterinary practice committee discovered, which is that there is no longer a shortage of food animal veterinarians but a problem of distribution and practice viability in certain underserved geographical areas,” said Dr. David Welch, project leader for the AABP Committee on Veterinary Practice Sustainability.

AABP President Nigel Cook says veterinary services need to adapt to maintain the profession’s presence on the farm. “There are many examples of successful practice models which expand veterinary services beyond traditional roles into consulting and facilitatory services, and the current concerns over pharmaceutical use and antimicrobial resistance, alongside animal welfare concerns, may ultimately create new opportunities not factored into this report,” Dr. Cook said. 

The AABP’s practice sustainability committee is searching out nontraditional business plans that will serve livestock owners’ veterinary needs better than the historic norm. Dr. Welch noted that the use of veterinary technicians to help in the provision of veterinary care is but one of several tactics being examined by the AABP and other veterinary organizations.

With the exception of the “magnitude” of the veterinary services surplus, the workforce study findings aren’t surprising, according to Dr. Harry Snelson, communications director for the American Association of Swine Veterinarians.

It makes sense, Dr. Snelson said, for veterinarians to congregate in regions where local economies are robust enough to sustain practices and families, as the study shows. But, he added, the rising cost of veterinary education is exacerbating the differential in the geographic distribution of veterinary services.

“The debt load of the average veterinary graduate has far outpaced the accepted cost of veterinary services in many areas and particularly in historically underserved geographic regions,” Dr. Snelson said.  “While (AASV) supports efforts to ease graduate debt through programs such as the Veterinary Medicine Loan Repayment Program, it is unlikely to solve the problem if the local underserved economy cannot sustain veterinary services.”

Nevertheless, Dr. Snelson believes a sizable population of food and companion animals in underserved areas would benefit from veterinary services. “The veterinary profession, regulators, and clients have to be willing to explore innovative approaches to effectively address the animal health and public health concerns that can no longer be met by traditional veterinary practice,” he said.

Next year, Student AVMA President Elise Ackley graduates from Louisiana State University into the veterinary workforce. The AVMA study findings are concerning, Ackley said, but she appreciates that they shed light on why so many veterinarians are struggling.

Despite the poor economic forecast for veterinary medicine, Ackley says she doesn’t regret her career choice.
“I have never once second-guessed my decision to enter veterinary school, and I think you will hear that from a good majority of veterinary students,” she explained.

“This is the perfect opportunity for our profession to step up and make smart decisions about better utilizing veterinarians that are, and will be, entering the workforce,” Ackley said.

“We the students,” she continued, “are looking to our parent organization, the AVMA, for strong leadership to refocus the profession to explore and recruit in the nontraditional areas of veterinary medicine, such as research, public health, and academia.”