AVMA President Testimony on the National Veterinary Medical Service Act


TESTIMONY OF

Gregory S. Hammer, DVM
President
American Veterinary Medical Association Concerning the
National Veterinary Medical Service Act
(P.L. 108-161)
2003

Before the
Subcommittee on Livestock, Dairy, and Poultry of the United States
House of Representatives Committee on Agriculture

February 7, 2008

Testimony of Dr. Gregory S. Hammer, President of the American Veterinary Medical Association, on the National Veterinary Medical Service Act


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"I know of no pursuit in which more real and important services can be rendered to any country than by improving its agriculture, its breed of useful animals, and other branches of a husbandman's cares."

George Washington
1732-1799
U.S. General
President
Letter, July 20, 1794

Thank you, Mr. Chairman and members of the Subcommittee, for giving the American Veterinary Medical Association the opportunity to speak in support of implementation of the National Veterinary Medical Service Act.

I am Dr. Gregory Hammer, President of the AVMA and a small animal and equine practitioner in Dover, Delaware. Prior to entering private practice, I held the rank of captain in the U.S. Air Force as a veterinary medical officer from January 1974 to January 1976.

The American Veterinary Medical Association represents more than 76,000 veterinarians engaged in every aspect of veterinary medical science. Among other things, we ensure the well-being of our nation's pets, we protect human health through the control of zoonotic disease, we conduct research into animal and human health, and we help preserve endangered species. Many of us are food supply veterinarians, working to ensure the health and safety of our nation's livestock.

Food supply veterinarians are the guardians of our nation's food supply – from poultry and swine to dairy cows and beef cattle – and they will be the first medical professionals to diagnose and contain diseases in animals that may spread to humans. These zoonotic diseases are increasing, as we have seen most recently with the spread of highly pathogenic avian influenza – or Bird Flu – from Asia to the Middle East and Europe. The exponential spread of infectious disease makes rapid diagnosis necessary if the disease is to be controlled.

Today, we are facing a shortage of food supply veterinarians. Their absence in many underserved and rural areas of our nation negatively impacts animal health and welfare, as well as public health. Not only is the food supply vital for obvious reasons, the economic activity generated by the food supply industry is also critical to our country's economy.

The American Veterinary Medical Association is committed to solving these shortages. The formation of the Food Supply Veterinary Medicine Coalition in May of 2004 shows how strongly the AVMA, and many other organizations, feel about solving this problem. The members of the Food Supply Veterinary Medicine Coalition are: the Academy of Veterinary Consultants, the American Association of Avian Pathologists, the American Association of Bovine Practitioners, the American Association of Food Hygiene Veterinarians, the American Association of Small Ruminant Practitioners, the American Association of Swine Veterinarians, the American Veterinary Medical Association, the Association of American Veterinary Medical Colleges and the United States Department of Agriculture's Food Safety and Inspection Service.

The Food Supply Veterinary Medicine Coalition has embarked on an aggressive mission to help curtail the shortage of food supply veterinarians. The Coalition funded a Kansas State University study to determine the extent of the shortage and how it impacts the American food supply. The study, published during the summer of 2006, indicates that, while projected demand for food supply veterinarians will increase 12 percent to 13 percent between now and 2016, a shortfall of 4 percent to 5 percent per year is projected.

One of the most recent developments toward helping solve the food supply veterinarian shortage is the creation of a section on the American Veterinary Medical Association Web site that highlights this situation. This Web site is part of our effort to help spread the news that food supply veterinary medicine is at a critical juncture and deserves national attention. The entities helping in this collaborative effort are sharing information, building coalitions, lobbying for legislation and trying to recruit more students into the food supply field.

Perhaps one of the most revealing programs undertaken by the Coalition is a series of maps created by the AVMA that provide a unique look into the state of food animal veterinary medicine and how a lack of practitioners is hitting some areas of the country much harder than others. By painstakingly comparing data from the AVMA and the United States Department of Agriculture, we were able to pinpoint the hot spots in each state were few – if any – food animal veterinarians reside or have a practice located. The maps also identify counties where veterinarians may be located but their numbers are insufficient to support the concentration of food animals located in that area.

What we found is that the ratio of food animals to food supply veterinarians in some states – like Wyoming – is fairly well balanced. It's a different story in other states, however. Take South Dakota, for instance, where more than a dozen counties have more than 25,000 food animals but no food animal veterinarians.

The National Veterinary Medical Service Act, which President Bush signed into law in December 2003, is a loan repayment program for veterinarians who pledge to practice in a variety of underserved areas, including food supply veterinary medicine. Under the law's current language, these veterinarians would receive debt forgiveness if they provide their services to geographic areas of need, areas of veterinary practice that are in need, areas of veterinary need in the federal government and other areas deemed appropriate by the Secretary of Agriculture.

The Act also creates a reserve corps – a "Veterinary National Guard" if you will – that will answer the government's call for assistance in the event of an animal disease emergency or disaster.

While the National Veterinary Medical Service Act has been law for more than four years, its rules remain unwritten, rendering the program nothing more than a paper tiger, powerless and ineffectual. What is most frustrating is that, while the law has been in place since 2003, the writing of the rules and the implementation of the Act have languished since its passage and even since it received its first funding more than two years ago.

This is unacceptable.

A few states, including Kansas, Ohio, Louisiana, Maine, Pennsylvania, Missouri and North Dakota, are picking up the ball that has been dropped by the federal government and are approving – and implementing – student loan repayment programs for veterinary school graduates who agree to serve in areas where food supply veterinarians are needed.

The AVMA also convened a National Veterinary Medical Service Act Advisory Group in January 2004 to address fundamental issues such as how a shortage would be defined, the objectives that such a program would meet and who would be eligible for the loan repayments – all in an effort to assist the USDA in implementing the program.

Our nation's 28 accredited veterinary colleges currently graduate about 2,500 veterinarians each year. According to a recent report by the Bureau of Labor Statistics, veterinary medicine ranked 9th in 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.

While some of that growth will be matched with the addition of new graduates into the workforce, there is no doubt that food supply and public health veterinarian jobs will be difficult to fill. There are about 8,850 U.S. veterinarians working in the food supply field. Around the turn of the 20th Century, virtually every veterinarian was a food animal veterinarian. Today, only about 17 percent of veterinarians work in food supply, while more than 70 percent of veterinarians work with companion animals. This trend is likely to continue as veterinary school graduates enter the workforce.

Of the 2007 veterinary school graduates who chose to begin work in the profession directly upon receiving their degrees, only about 14 percent chose food supply veterinary medicine, while more than 41 percent chose small animal practice and about 4 percent chose equine practice. Reducing this employment pool even further is the fact that about 37 percent of graduates decided to pursue advanced study programs.

One of the biggest obstacles standing in the way of students pursuing a career in food supply veterinary medicine is educational debt. It is estimated that the average student debt for a veterinary school graduate now exceeds $106,000. That debt has increased by almost 35 percent since the National Veterinary Medical Service Act was signed into law in 2003.

As these figures illustrate, it is no easy task earning a degree in veterinary medicine. Even more obvious is that it is very costly to become a veterinarian. Upon graduation, most of these newly educated veterinarians must find a job that not only meets their daily living expenses, but also helps them pay down their student debt. This can be a daunting task, especially when we consider salary levels for new graduates entering the workforce. The mean starting salary for new graduates was about $57,969 in 2007. Those veterinarians entering large and mixed animal practice were compensated below that average.

The highest paying jobs in each of the practice categories are typically determined by geography, which more often than not dictates the level of salary. Jobs in many rural areas, where food supply veterinarians are in the highest demand, often pay less due to demographics and other economic conditions. The National Veterinary Medical Service Act, once implemented and operational, will help defray some of this debt, making these rural areas -– and these food supply veterinarian jobs – more attractive to prospective job candidates.

With the mean age of food supply veterinarians hovering around 50, many practitioners will be considering retirement in the not-too-distant future, placing an even greater burden on the profession and our society.

Mr. Chairman, as stated in the invitation to attend this hearing, our purpose here is to "review the National Veterinary Medical Service Act." I hope I have laid the groundwork for why we believe fully funding and implementing this legislation is so important. Much remains to be done, however, and the AVMA has questions about why it has taken so long for the United States Department of Agriculture to answer Congress' call to action.

A letter from then-Secretary of Agriculture Ann Veneman to Representative Bob Goodlatte dated July 29, 2004, states, "As the front line of defense in the war against animal diseases, USDA is keenly aware of the serious need for veterinarians in certain geographical and practice areas. In addition to the areas mentioned in the bill, USDA has been working with the American Veterinary Medical Association to identify other areas of veterinarian shortage." While this is indeed the case – that the USDA has worked with the AVMA to identify areas of veterinarian shortage – most of that data came from work done by the AVMA and its staff. Now we are waiting for the USDA to fulfill their responsibility and answer our calls for written rules and implementation of the National Veterinary Medical Service Act.

Written responses dated June 22, 2006, from Dr. Gary Sherman, National Program Leader of Plant and Animal Systems, to questions posed to the USDA about the status of the Act leave us more frustrated than satisfied about its future.

Dr. Sherman stated in one response that "substantial progress" has been made "to develop a veterinary educational loan repayment program consistent with the spirit and the letter of the NVMSA." We, however, at the AVMA have not received any details as to what "substantial progress" means.

Another response states that the "NVMSA Working Group within USDA CSREES has developed a series of whitepapers describing potential programmatic strategies for implementing NVMSA." We at the AVMA have not received a copy of these whitepapers, nor has the working group shared their content with us.

It was also stated that the NVMSA Working Group "has developed a 2-phase draft strategy, the first of which is anticipated to lead to distribution of awards as early as fall of 2006." These distributions are going to Food Safety and Inspection Service veterinarians through a reprogramming of funds to a pre-existing loan repayment program previously funded by FSIS. While the AVMA is grateful for the governmental assistance this program receives, the monies going to FSIS were supposed to go to the National Veterinary Medical Service Act, which still awaits implementation.

In another response, it was indicated that the USDA is working on a "longer-term strategy that provides a mechanism to obtain validated veterinary workforce needs estimates for the various sectors identified in the Act." We respectfully ask where that work stands, especially in light of the fact that the AVMA supplied much of the data from the Food Supply Veterinary Medicine Coalition study and the food supply distribution maps mentioned earlier in my testimony – and in light of the fact that the data has generated significant support from many others in the scientific and government communities.

Apart from these unanswered questions, we also have other concerns.

The USDA last year granted the Cooperative State Research, Education, and Extension Service authority to implement the National Veterinary Medical Service Act. We have learned, however, that CSREES says it does not have the capability to administer and develop the program. We question this because it is our understanding that CSREES has rule writers on staff. If that is the case, we must assume they have a management analyst on staff who can lead the rules-writing process. If CSREES does not have a management analyst, they are free to ask other agencies for help in the rules writing.

As a response to the USDA's inaction on NVMSA, the United States Senate has called for amendments to the Act in the 2007 Farm Bill. We support these amendments. The amendments call for halting the transfer of money away from NVMSA to FSIS. They underscore the importance of limiting the application of funds for their original intent – support of rural large and mixed veterinary practices. And the amendments provide a deadline by which USDA must promulgate the rules of the Act.

Mr. Chairman, and members of the Subcommittee, veterinary students are, by their very nature, dedicated to the care of animals. They are also keenly aware of the many critical roles veterinarians play in our society. But while many of these veterinary students are aware of the career opportunities in food supply veterinary medicine, there are many societal factors involved in their decision as to where to practice medicine. Perhaps the biggest factor in their decision is the salary they can earn to provide for themselves and their family. Members of Congress and President Bush realized that they could play a role in making that decision a bit easier by passing and signing into law the National Veterinary Medical Service Act.

You fulfilled your responsibility. Now we ask that the USDA fulfill theirs.

We ask that the USDA go on record about what resources they need in order to implement the National Veterinary Medical Service Act. If they need money for the program, tell us how much. If they need staff members to develop and implement the program, tell us how many. If they need help in writing the rules, ask for assistance.

The AVMA stands ready to assist in the development and implementation process in any way possible. I believe we have already shown our commitment to doing so by detailing our involvement in the process through both the written and oral testimony I have provided to you today.

In closing, the problems that the National Veterinary Medical Service Act will address worsen each and every day the program remains nonfunctional. This has all the makings of a crisis if we don't act now and implement the National Veterinary Medical Service Act.