AVMA Testimony for the hearing on Protecting Animal and Public Health: Homeland Security and the Federal Veterinarian Workforce


TESTIMONY

of the

American Veterinary Medical Association delivered by
W. Ron DeHaven, D.V.M., M.B.A., Chief Executive Officer

for the hearing on
Protecting Animal and Public Health:
Homeland Security and the Federal Veterinarian Workforce

Before the
U.S. Senate Subcommittee on
Oversight of Government Management, the Federal Workforce,
and the District of Columbia

2:30 p.m., Thursday, February 26, 2009
342 Dirksen Senate Office Building


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Thank you, Mr. Chairman, and members of the Subcommittee. I am Dr. Ron DeHaven, chief executive officer of the American Veterinary Medical Association (AVMA), which represents more than 78,000 veterinarians across the United States.

I appreciate the opportunity to testify before you today on the state of our nation's veterinary workforce. I would also like to thank the Government Accountability Office for involving us in the information-gathering process for its exhaustive report, "Veterinarian Workforce, Actions are Needed to Ensure Sufficient Capacity for Protecting Public and Animal Health."

While the general public associates veterinarians with the care of their pets, this report highlights the critical role veterinarians in public and private practice have in ensuring food safety and promoting public health.

The information contained in the report, Mr. Chairman, is invaluable for coming to grips with the problem of our national veterinarian shortage. We are pleased to have the report confirm our concerns about the widespread shortage of veterinarians; concerns that we have carried to meeting rooms, state houses and even here - to Capitol Hill - for some time.

The report, however, is also sobering and frightening.

What is especially alarming is to see in black-and-white how ill-prepared our nation appears to be in the event of a pandemic. Equally disconcerting is the lack of an integrated approach for assessing the current and future sufficiency of the veterinary workforce by many federal agencies that rely on veterinarians to fill critically important public health, food safety and animal health roles.

As the title of the report so accurately underscores, it is time to take action. We must remove our blinders and expand our collective view of the problem so that we can move quickly if we are going to be able to provide Americans a safe, healthy and secure food supply, and protect them from disease outbreaks and pandemics.

Veterinary care is critical in both regards. According to the Centers for Disease Control and Prevention, foodborne diseases, such as Campylobacter, Salmonella and E. coli, are responsible for an estimated 76 million human illnesses, 300,000 hospitalizations and 5,000 deaths in the United States every year.

As our nation continues to rely on protein-based diets, the number of food animals required to meet this need will rise proportionately with population growth. And it is clear that this desire for meat products is growing. The demand is so great in this country that more than 85 billion pounds of meat and poultry are processed here each year.

And the U.S. is not alone. About a quarter of U.S. beef and pork is exported to feed hungry mouths around the world. While China is now the world's largest consumer of meat, in Mexico, meat consumption has increased by 50 percent since 1990.

Global population growth and the growing dependence on food animal protein will put increased demands on our food supply system and those who are responsible for its security, safety and quality. Veterinarians are, and will continue to be, on the front lines of that effort.

At the same time, veterinarians play an integral role in protecting humans from disease. For more than 100 years, veterinarians have been responsible for some of the most significant advances in public health, including the near eradication of diseases such as tuberculosis and brucellosis in domestic animals. Severe acute respiratory syndrome, monkeypox, West Nile Virus, Lyme disease, avian influenza and bovine spongiform encephalopathy are more recent examples of diseases that have had significant public health implications, and veterinarians have played a vital role in the identification, diagnosis, control and surveillance of each one of these diseases.

Unfortunately, the number of veterinarians available to serve in key public health roles does not meet current demand, and the situation will only get worse without aggressive intervention now. A study conducted at Kansas State University for the Food Supply Veterinary Medicine Coalition, to which the AVMA belongs, projects the shortage of food supply veterinarians to worsen by 4 percent to 5 percent annually for the next several years. And as the GAO report indicates, this shortage is being felt across the board, from the United States Department of Agriculture, to the Food and Drug Administration and other federal agencies, as well as in the private sector.

Retirements, as noted in the GAO report, are also weighing heavily on the current veterinary workforce, and these retirements are expected to have an even greater impact in the future. Many federal and food safety veterinarians answered the call to public service back in the 1960s and '70s, and they are aging. As they near retirement, we can expect an even greater burden being placed on the profession and our food supply system.

According to a recent report by the U.S. Bureau of Labor Statistics, veterinary medicine is ranked 9th on the list of the 30 fastest-growing occupations for 2006 through 2016. It is estimated that jobs for veterinarians will increase by 35 percent in the next several years. Will the federal government be able to compete for the fewer available veterinarians in the face of this increasing demand?

While some of the expected growth will be met with the addition of new graduates into the workforce, there are national concerns that veterinary jobs across the professional spectrum will go unfilled, particularly those related to public health and food safety.

Around the turn of the 20th Century, virtually every veterinarian was a food supply veterinarian. Today, only about 10 percent of veterinarians work to ensure a safe, affordable and abundant food supply.

The causes of the shortage are many and complex.

A look at our nation's changing demographics shows that a growing disconnect from rural living and life on the farm is contributing to fewer students pursuing a career in food supply veterinary medicine. As our nation becomes more urban in nature, people are moving out of rural America and seeking to make a living in more populated areas, which is contributing to the shortage of food supply and federal veterinarians.

As farming operations become more consolidated, the links in the family farming chain - and the important exposure to the veterinarians who help these families care for their animals - are weakening, leading to fewer food supply veterinarians.

The 28 accredited veterinary colleges in the United States graduate about 2,600 veterinarians each year, and that number has remained relatively stagnant for the past two decades.

This lack of growth in veterinary graduates is not due to a lack of applicants. According to the Association of American Veterinary Medical Colleges, these 28 veterinary schools in the United States are at full capacity, with qualified applicants outnumbering available seats three to one.

The one limiting factor that all veterinary schools have in terms of graduating more veterinarians who will go into public practice areas is the construction of the unique space needed to educate veterinary students. As the Association states, this is not generic university space. It is unique teaching, diagnostic, laboratory and research space that must include special safety, restraint and animal-handling features that are not commonly found on American campuses.

Educational debt is another obstacle standing in the way of students pursuing a career in food supply and public health veterinary medicine. It is estimated that the average student debt for a veterinary school graduate in 2008 exceeded $120,000, up from about $106,000 in 2007. Among all graduates, more than a third incurred debt of $130,000 or more. About 90 percent of the average debt of graduating veterinarians was incurred while they were in veterinary medical college.

When it comes to federal veterinarians employed by the USDA, FDA and the U.S. Army, the AVMA shares the concerns expressed in the GAO report about the inadequate level of pay they receive. Each of these agencies cited noncompetitive salaries as an area of concern when it comes to recruiting and retaining federal veterinarians.

Addressing this disparity is one of the AVMA's highest priorities, and we are working with the National Association of Federal Veterinarians to improve the recruitment and retention incentives available for federal agencies. It is more lucrative for veterinarians to seek a career in private practice, and if the federal government is to increase the number of federal veterinarians, it will have to improve salaries and benefits.

The AVMA and many of its veterinary partners have already taken action to address the veterinarian shortage. This issue has been an AVMA priority for many years. The shortage of food supply veterinarians, particularly those practicing in rural areas and those working for the federal government, is a primary focus of ours, and the GAO report validates what we have been saying since at least 2004 - that this country is facing a crisis if we do not act and bolster our veterinary forces.

Through partnerships and professional relationships with several organizations such as the FFA (formerly known as the Future Farmers of America), the National Association of Agricultural Educators and the National Science Teachers Association, the AVMA is reaching out to students to help attract bright, young minds to the veterinary profession. We have created career videos and use social media to distribute information on veterinary careers and the rewards of working with food animals and on behalf of public health.

Through our involvement with the Food Supply Veterinary Medicine Coalition, we established a Food Supply Veterinary Medicine section of our Web site that focuses on food animal and public health sector careers. The site is full of information about careers in food supply veterinary medicine, why it's such a critical field and which states are being hit harder than others by the shortage of food supply veterinarians.

When it comes to our colleges of veterinary medicine, the AVMA is working tirelessly with the Association of American Veterinary Medical Colleges to find ways to attract more students into food supply veterinary medicine and public health careers.

From externship, preceptorship and incentive programs, to scholarships and early admission initiatives, colleges are teaming up with industry and other partners to introduce veterinary students to food supply and public health careers while also trying to ease their financial burden.

Many states, with assistance from the AVMA, have established student loan repayment programs for graduates who commit to serving in areas of need, particularly in rural areas, and in the field of food supply veterinary medicine. However, due to financial troubles at the state level, many of these programs go unfunded.

Although we are making some progress, we are still faced with the reality of veterinary colleges bursting at the seams and educational debt overwhelming new graduates.

Any assistance that can be offered to veterinary students - whether in the form of scholarships, grants or low-cost loans - to help cover the cost of earning a veterinary degree is not just beneficial to the student. Such assistance helps all of society by ensuring that veterinarians - those medical professionals whose expertise serves all species - are there for our nation when we need them.

An example of this type of assistance is the National Veterinary Medical Service Act, which exchanges debt relief for service in areas of societal need. The program was signed into law in 2003, and the AVMA is grateful that Congress has appropriated some funds for the program.

However, despite the program's good intentions, no benefits have been realized due to limitations in funding, delays in implementation and the fact that the loan payments are subject to taxation. It is also worth noting here that, more than five years after passage of the legislation, the first cycle of the program's veterinary loan repayments has yet to be awarded.

Our concerns about the National Veterinary Medical Service Act are echoed in the GAO report, which indicates that officials from the U.S. Department of Agriculture believe the money allocated to the program thus far is insufficient and would have minimal impact on the shortage.

The current funding of only about $1.9 million since the inception of the program, coupled with the fact that the monies are taxable income for the recipients, greatly diminish the program's effectiveness. As it stands today, about 46 veterinarians could benefit from the program. If payments under the program were made tax-exempt, the number of program participants would increase to 75.

Each dollar spent on taxes in this program means one less dollar available for loan repayment. So we respectfully ask that Congress assist us by making the program tax-exempt for the recipients.

There is an existing federal loan repayment program the agencies can use as an incentive to attract veterinarians. However, the loan repayments under this existing federal program are capped at $10,000 a year and $60,000 overall. This program also needs to be made tax-exempt for the recipients. With an average debt of $120,000, these payments are an inadequate incentive for students to choose careers in shortage areas, and they need to be increased.

Although many veterinarians who would benefit from a robust loan repayment program would ultimately find work in the private sector, these same veterinarians are often called to action by federal and state agencies during large disease outbreaks. According to the GAO report, federal and state officials said one of the biggest challenges they faced during recent zoonotic disease outbreaks was having too few veterinarians to control the outbreak while also adequately carrying out routine activities. These incidents included a bovine tuberculosis outbreak in Michigan; a West Nile outbreak in Colorado; and an exotic Newcastle disease outbreak in California.

According to the report, the exotic Newcastle disease outbreak quickly exhausted California's supply of veterinarians, both at state and federal agencies, because so many backyard birds - which are kept as a hobby or for personal consumption - were affected. Even with a task force of more than 6,000 veterinarians responding, it took almost a year to control the outbreak.

Having more veterinarians in both the public and private sector would help us prevent a recurrence of this type of situation. An increase in numbers would not only improve our nation's ability to fulfill its daily responsibilities to animal and human health, it would also add to the existing National Animal Health Emergency Response Corps to held answer the government's call for assistance in the event of an animal disease emergency or disaster without totally depleting our veterinary workforce.

Congress has also shown its support for the situations facing our veterinary colleges. When it enacted the Higher Education Opportunity Act last year, it included the School of Veterinary Medicine Competitive Grant Program, which is intended to increase the number of veterinarians in the workforce through grants designed to increase capacity at our 28 veterinary colleges. The program language, however, states only that the grants can be used for minor renovation projects for classroom space, libraries or laboratories.

To be frank, Mr. Chairman, we are beyond the point of needing minor renovations to our schools of veterinary medicine, and I believe the GAO report's findings reflect that reality. Minor renovations would not allow our veterinary schools to increase class size to a level that is needed to meet the demand for more veterinarians, both in the private and public sectors. We need major renovations, and we ask that Congress assist us in meeting this critical infrastructure need.

Along with an increase in appropriations to allow for more extensive construction projects, we also respectfully request that the Department of Health and Human Services, which is responsible for promulgating the regulations for the grant program, do so as soon as possible so that we can begin the process of awarding these grants. We ask that the Department seek input from the AVMA in the rules-writing process, and we would welcome the opportunity to do so.

Mr. Chairman, we are all keenly aware of the tough economic times gripping our nation. But as the old adage goes, we can pay now or we can pay later. If we choose the latter, the ultimate cost will be exponentially higher. The cost of expanding our veterinary schools and providing debt forgiveness to our graduating veterinarians pales in comparison to the potentially huge costs associated with animal and human disease outbreaks.

Few jobs are more important when it comes to food safety and public health than that of the veterinarian. They are not only promoting the health and well-being of our livestock herds and poultry flocks, veterinarians are also first responders on the front lines of disease prevention and response.

Their involvement in food safety plays a vital role in public health and national security. Part of our responsibility as veterinarians is to make sure we cultivate and mentor more veterinarians to fill these roles, and we ask that you provide us more tools to do this job.

The findings in the GAO report present us with significant challenges and opportunities. I am confident that by working together, we can address these challenges, welcome more bright minds into the veterinary profession and provide our citizens the level of food safety and security they deserve and expect.

Thank you.