Address to the American Veterinary Medical Association House of Delegates

July 19, 2011

Is Our Iceberg Melting for the 21st Century?

In July 2009, at the Candidate's Introductory Breakfast in Seattle, I distributed Colorado Spruce seedlings. They were a symbol for "planting" ahead for our professional future. This message is about such an effort and investment today for the benefit of individual veterinarians, veterinary medicine and AVMA tomorrow.

In 1761, Claude Bourgelat saw the need for a school of veterinary medical instruction. It was a new beginning for what was to come. And now, 250 years later, we celebrate World Veterinary Year with 78 other countries for what veterinary medicine has accomplished and what it has become. In 1863, a handful of veterinarians in the United States saw the need to form an association for veterinary medicine, and held the first national convention of veterinary surgeons in New York with 40 delegates from seven states. Originally called the USVMA, in 1889 it became known as the AVMA. It was a new beginning that has grown into the organization we see today.

In 1974, when I entered the University of Minnesota, the median household income was $11,200, the cost of a postage stamp was 10 cents, and the Dow Jones hit a yearly high of 950. The Internet had just come into being. Today 43 percent of our AVMA members have no idea what life was like before the Internet existed. The world is changing even more quickly now than in 1974. The visionary CEO's of Google and YouTube, Facebook, Apple and Microsoft are changing the way we live.

Our members are changing. We want instant access, instant involvement and two-way communication. AVMA must change as well to remain relevant to its members. It will take the courage of this profession's leadership to make the changes required. It will take persistence of leadership for years to come.

What does our future look like? It is one you helped envision and one you must now help us achieve.

  • It is a future where a career in veterinary medicine is financially rewarding for the education we received and the services we provide; it does not burden us financially for decades to come.
  • It is a future with an efficient veterinary medical education system that continues to be the envy of the world; one that probably will not look like the one we currently have.
  • It is a future with an AVMA that practices open leadership, engages openly and transparently with members at many levels, and holds a place of high respect and esteem throughout the world.
  • It is a future with a public that recognizes veterinarians as respected and required contributors to public health and "One Health" teams in many communities and nations, a public who understands we oversee an economically produced, safe food supply for the 7 billion people who inhabit this planet, and who care about the humane care of those animals.

This is a defining time for transformation of veterinary medicine and the AVMA. What better year to start than World Veterinary Year. 2011 is a prelude for AVMA's 150th anniversary celebration in 2013. The last 150 years are memorable and cherished. We tend to hold onto cherished history, memories and methods. Where we came from is important, yet not nearly as important as where we will go!

This is a "call to action," AVMA, for us to urgently address three of the five newly approved Strategic Plan initiatives: Economics, Education and Governance.

2011 is the beginning of a new era for economic viability, educational renewal and association functionality.

Let's look at Economics. If any of us had a patient (let's say the veterinary medical profession) that presented with a multitude of symptoms as a problem list (i.e., high student debt, inadequate return on one's educational investment in terms of compensation, decreased employment, high cost educational infrastructure, inadequate sustainability in rural environments and decreased visits to veterinarians), we would search for answers in terms of data collection and a diagnosis before that patient's condition worsened. We would design a treatment plan to improve the patient's health, with the goal of returning that patient to better condition than when first presented. The management of this patient requires such a treatment plan – that is, a comprehensive strategy for the economic development of veterinary medicine.

This process starts next month when the AVMA Executive Board and invited consultants meet for an economic working session where we dedicate significant time and energy solely to how to collect that data and develop a treatment plan. It is also important to engage the public in dialogue as consumers of our services, listen to their needs and expectations, and enhance their understanding and value of trusting a veterinarian for their animal health care procedures, because we have the compassion, knowledge, credibility and accountability for those services.

We need to understand the power of the public in today's world when it comes to transparent communication and demand for our services. We have been silent and quietly revered heroes for too long. It is time veterinarians make their case for animal health and welfare, preventive medicine, food safety and One Health, and tell the whole world about it.

Let's look at Education. If our practices had increasingly high overhead, were struggling to generate enough revenue to pay the bills, had difficulty in retaining staff members because of more lucrative jobs elsewhere and continually raised fees to our clients (in this case, students), while decreasing clients' experiences (in this case, increasing the student to faculty ratio), we would need to look at some new options.

AVMA and AAVMC must come together to improve the efficiency of delivery of veterinary medical education, while heightening the world-class competency and increased confidence of graduates for entrance into a national and increasingly international marketplace. The AVMA is a partnered member of NAVMEC, the North American Veterinary Medical Education Consortium. NAVMEC's final draft is being presented to the AAVMC Board of Directors at their meeting during this convention. It represents collaboration among academia, practitioners, and several organizations and individuals to develop a road map for these very changes. We can use this report as a guide, if adopted, to energize educational transformation, to include the medical skills and the nontechnical life skills needed for the next generation of veterinarians. We need to infuse both imagination and innovation to streamline education, much as private enterprise uses imagination and innovation to be the best in the world. If our current system doesn't do it, private enterprise will do it. They are already starting to do it.

Let's look at Governance. Two years ago at the Candidates' Introductory Breakfast, I showed you a video clip from YouTube from the "Did you Know" series on the speed of communication around the world, and how people today want to be involved in making the decisions, not just to be affected by those decisions. You, our very own House of Delegates, have expressed this very same sentiment repeatedly.

Dr. King reported on the Vision 20/20 Commission's Report yesterday, which states, "In order to transform the profession, AVMA must first transform itself and change in profound ways." Our demographics have changed. Our overall leadership doesn't look like our members, and our profession doesn't look like society.

In Charlene Li's book, "Open Leadership," she states, "We need to be asking the right question -how do we develop the kind of new, open, engaged relationships we need to get our messages across?" It takes trust from repeated successful interchanges of people sharing their thoughts, activities and concerns. If we buy something, it is because we want it, we value it. We must determine what is of value to the consumers of our services and to our members, including how we govern ourselves and engage our members.

This will be a new AVMA, one that will be more interactive and program-based for the benefit of our members and the public; one that will engage and empower its members to be the authorities and leaders on issues of veterinary medicine; one that is fully engaged in global relationships and the global economy. If anyone is unsure about the importance of our global influence, AVMA has not done its job of communicating the value of our global influence to our own members. It is that simple. Several resolutions today will start discussions on governance and our global engagement. Let's look forward, not behind.

We need to transform ourselves to an "abundance mentality" – the belief that plenty of work exists for everyone. Certainly that should be true with 311 million people in this country and almost 7 billion people in the world, and with all the animals with which we enjoy life or upon which we depend. We need to put our energy and resources into positive value messages for the public so they understand the importance of what we do for animals, people and environmental health, the One Health philosophy; that is how to increase demand rather than the defensive postures and attitudes that lead to mistrust by others. We must make the positive connection of the importance of veterinary medicine to each person in their own world.

Finally, how do we make sure this transformation, this time will be successful? After all, we have been talking about how to improve economics, educational efficiency and AVMA governance for decades.

During the final day of the third meeting of NAVMEC in July of 2010, we had a videoconference with John Kotter, possibly the most renowned expert in the world on leading significant change within organizations and industries, a professor and prolific author at Harvard Business School. He recently wrote a parable called "Our Iceberg is Melting," about penguins realizing the way of life they had known for centuries was at risk. They needed to change to survive. John Kotter has researched and analyzed years of organizational change events and documented what he feels is the most successful process for initiating and accomplishing significant change. He lists four clear and simple steps, although he has written volumes on how to accomplish them. We need to set the stage for the need to change, decide what to do, make it happen and make it stick.

This is an ambitious vision, one that requires ambitious plans to improve the financial well-being of this profession, to help transform our educational process, and to excite a more diverse population of veterinarians to engage with AVMA, for which membership continues to be a matter of pride, service and reward. It will be a decade of commitment. We have already started.

On economics, your Executive Board is dedicating 1.5 days in August solely to a strategic economic working session. The Partnership for Preventive Pet Healthcare will educate the public about the importance of preventive health care for their pets and will be unveiled at this convention. On education, the NAVMEC report is finalized and will be considered by the AAVMC Board this week. On governance and engagement, a state-of-the-art AVMA website is being diligently developed. The Executive Board approved a new virtual community for recent graduates and an Early Career Development Committee. As delegates, you discussed tactics for achieving the Strategic Plan objectives in your reference committees and will soon debate resolutions on this topic.

For this vision to become reality, we must truly believe in the urgency for change and its achievability. We must commit the time, persistence, money and resources to develop plans for change that we can monitor and measure.

We have everything we need in place to effect these changes. We have a will on the part of leadership, a strong organizational base with interested members and an exceptional staff that is ready, willing and able to help us get it done. We have gathered valuable insight from our members, through you – the House of Delegates – the 20/20 Vision Commission and our strategic planning process. All we need to do is mobilize and direct that energy toward these common goals. It can be done. And I am telling you, it must be done.

My personal vision for veterinary medicine is that one day, when parents are asked what profession they would like their sons and daughters to pursue when they grow up, the parents will answer "A veterinarian!" for its financial and public prestige. Nine of the top-ten, top-paying jobs in America in 2011 are owned by medical professionals, including oral surgeons and orthodontists. (The other nonmedical job is CEO of a major corporation.) Veterinarians should be on that list. Why aren't we? We have to connect the value of veterinary medicine to every person's personal and professional life. If we create the understanding, the desire and demand for veterinary care and consultation will follow because of its significance in some way to each person.

For the past 33 years, I cannot imagine having done anything else other than be a veterinarian. There is no profession with greater people, with more desire to work long hours to help people and animals, no profession that is so small and yet does so much for animals and humanity with so little recognition for both our education and services.

Once someone finds out you are a veterinarian, you are loved and revered almost anywhere in the world. We must emphasize the value of veterinary medicine to each person, which will lead to greater demand for our unique and sophisticated services. We have a vision for a better economic status, transformed educational models and improved AVMA governance. We simply must act to make it happen and make it stick. This is the time to come together. If we commit to these goals, we will make a difference for generations to come.